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Individual

SHANELLE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
405 FREDERICK RD, STE 162, CATONSVILLE, MD 21228
(443) 637-1007
Mailing address
405 FREDERICK RD, STE 162, CATONSVILLE, MD 21228
(443) 637-1002

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R205058
MD

Other

Enumeration date
10/05/2023
Last updated
12/20/2023
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