Individual
MIQUELLE M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
9600 S 1300 E, SUITE 302, SANDY, UT 84094-3766
(801) 571-0009
(801) 576-1085
Mailing address
9600 S 1300 E, SUITE 302, SANDY, UT 84094-3766
(801) 571-0009
(801) 576-1085
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
219852-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
219852-4405
STATE LICENSE
UT
Enumeration date
05/17/2007
Last updated
07/08/2007
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