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Individual

MS. DANIELLE MICHEL SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
18101 OAKWOOD BLVD, ISU-OBS, DEARBORN, MI 48123-4089
(313) 982-5770
(313) 982-5771
Mailing address
23300 ECORSE RD, TAYLOR, MI 48180-1768
(313) 291-9500
(313) 291-6694

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704194031
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10-4559012
MI
05
10-4559021
MI
05
10-4559030
MI
05
10-4559040
MI
05
10-4559059
MI
05
10-4636630
MI
01
11712584
CAQH
Enumeration date
01/09/2006
Last updated
09/21/2017
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