Individual
MRS. MISCHERYL ANTOINETTE SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7707 W GLENBROOK RD, MILWAUKEE, WI 53223-1060
(414) 355-9903
Mailing address
7707 W GLENBROOK RD, MILWAUKEE, WI 53223-1060
(414) 355-9903
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39985100
PROVIDER NUMBER
WI
Enumeration date
03/31/2006
Last updated
07/08/2007
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