Individual
MICHAELA D SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
768 AVERY BLVD N, RIDGELAND, MS 39157-5219
(601) 487-6482
Mailing address
175 BELLE OAK DR, BRANDON, MS 39042-8254
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
910936
MS
363LF0000X
Family Nurse Practitioner
Primary
906388
MS
Other
Enumeration date
03/15/2022
Last updated
12/11/2023
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