Individual
KELLY J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 N PARK ST, WEST MICHIGAN CANCER CENTER, KALAMAZOO, MI 49007-3731
(269) 382-2500
(269) 373-7478
Mailing address
200 N PARK ST, KALAMAZOO, MI 49007-3731
(269) 382-2500
(269) 373-7478
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704152480
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4631966
—
MI
Enumeration date
03/03/2006
Last updated
11/17/2020
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