Individual
EUGENIA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
400 MACK AVE, DETROIT, MI 48201-2136
(877) 929-6342
Mailing address
32556 FIRWOOD DR, WARREN, MI 48088-1544
(248) 497-6507
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3704241370
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3704241370
APRN LICENSE
MI
Enumeration date
07/09/2021
Last updated
07/09/2021
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