Individual
HOLLY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1109 COBB AVE, KALAMAZOO, MI 49007-2449
(910) 650-8828
Mailing address
167 N DRAKE RD, P.O BOX 20421, KALAMAZOO, MI 49009
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703120614
MI
1710I1003X
Independent Duty Medical Technicians
—
—
171400000X
Health & Wellness Coach
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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