Individual
MRS. JACQUELINE ELIZABETH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
29877 TELEGRAPH RD, SUITE 401, SOUTHFIELD, MI 48034-1332
(248) 651-8344
Mailing address
29877 TELEGRAPH RD, SUITE 401, SOUTHFIELD, MI 48034-1332
(248) 651-8344
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704236096
MI
Other
Enumeration date
07/23/2015
Last updated
09/25/2019
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