Individual
SHANNON RAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1102 E MICHIGAN AVE, JACKSON, MI 49201-1802
(517) 205-7299
Mailing address
1102 E MICHIGAN AVE, JACKSON, MI 49201-1802
(517) 205-7299
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704291706
MI
Other
Enumeration date
09/28/2020
Last updated
09/29/2025
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