Individual
MAMIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N
Contact information
Practice address
9010 W PORTAGE ST, MILWAUKEE, WI 53224-4034
(414) 218-8017
Mailing address
9010 W PORTAGE ST, MILWAUKEE, WI 53224-4034
(414) 218-8017
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
118381-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39887600
—
WI
Enumeration date
05/28/2008
Last updated
05/28/2008
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