Individual
JULIA ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
811 W BROADWAY AVE, MEDFORD, WI 54451-1307
(715) 748-5580
Mailing address
244 E 2ND AVE, STANLEY, WI 54768-1210
(715) 703-0035
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
7543-33
WI
363LG0600X
Gerontology Nurse Practitioner
7543-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7543-33
WISCONSIN ADVANCED PRACTICE NURSE PRESCRIBER
WI
Enumeration date
02/16/2017
Last updated
02/16/2017
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