Individual
MS. KATHRYN LOUISE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
44250 DEQUINDRE RD, STERLING HEIGHTS, MI 48314-1002
(248) 964-6101
(248) 964-9888
Mailing address
130 TOWN CENTER DR STE 203, TROY, MI 48084-1744
(248) 585-8250
(248) 585-8270
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704119154
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50-0866033-0
BCBSM
MI
Enumeration date
10/17/2006
Last updated
07/21/2022
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