Individual
NICOLE RAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2600 65TH AVE, OSCEOLA, WI 54020-4370
(715) 294-2111
(715) 294-5758
Mailing address
PO BOX 218, OSCEOLA, WI 54020-0218
(715) 294-2111
(715) 294-5758
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
61379
WI
Other
Enumeration date
05/02/2010
Last updated
05/16/2014
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