Individual
AUTUMN ILENE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704297283
MI
363LA2100X
Acute Care Nurse Practitioner
4704297283NSA200T4
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704297283NSA200T4
APRN SPECIALTY CERTIFICATION
MI
Enumeration date
01/29/2021
Last updated
03/20/2023
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