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Individual

CLARE ELIZABETH SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 940-0040
Mailing address
23948 NANCY DR, SAND LAKE, MI 49343-9788
(720) 757-2835

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703125855
MI

Other

Enumeration date
12/28/2021
Last updated
12/28/2021
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