Individual
STEPHANIE DORA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
275 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2531
(616) 267-7104
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
4704272685
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704272685
MI
Other
Enumeration date
09/29/2012
Last updated
01/29/2025
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