Individual
NICOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2858 KINGSTON DR, MADISON, WI 53713-2849
(608) 298-7180
(608) 241-8414
Mailing address
2862 KINGSTON DR, MADISON, WI 53713-2849
(608) 298-7180
(608) 241-8414
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310423-031
WI
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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