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Individual

ANDREW BRYAN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
7575 GRAND RIVER RD, BRIGHTON, MI 48114-9309
(810) 844-7575
Mailing address
1668 SAVANNAH CT, YPSILANTI, MI 48198-3682
(517) 281-6529

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
124782
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
238552-30
STATE RN LICENSE
WI
01
4704287625
STATE RN LICENSE
MI
Enumeration date
12/24/2018
Last updated
12/24/2018
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