Individual
LAURE SUE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1611 OAK AVE, MUSKEGON, MI 49442-2468
(231) 767-1921
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703112325
MI
Other
Enumeration date
11/22/2024
Last updated
11/22/2024
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