Individual
ANNALISSA KAMMEYER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1818 CAREW ST STE 120, FORT WAYNE, IN 46805-4764
(260) 425-6200
(260) 425-6205
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02007064A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2020
Last updated
08/30/2023
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