Individual
MRS. MICHELLE MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N. W.H.N.P.
Contact information
Practice address
999 S FAIRMONT AVE, 235, LODI, CA 95240-5100
(209) 334-3333
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
14526
CA
Other
Enumeration date
03/21/2007
Last updated
09/06/2013
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