Individual
MS. MICHELLE LISA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
982 E MAIN ST, BRIDGEPORT, CT 06608-1913
(203) 696-3260
(203) 332-0376
Mailing address
1190 SYLVAN AVE, BRIDGEPORT, CT 06606-3063
(203) 556-2315
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
004752
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004234788
—
CT
Enumeration date
09/07/2011
Last updated
03/20/2014
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