Individual
NICOLE SHERAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CRNA
Contact information
Practice address
333 COTTMAN AVE, PHILA, PA 19111-2434
(267) 990-1028
Mailing address
714 LINCOLN AVE, PROSPECT PARK, PA 19076-2302
(215) 990-8232
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN615430
PA
Other
Enumeration date
11/15/2021
Last updated
12/14/2021
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