Individual
MISS HALEY MICHELLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
25 KNISKERN AVE, MECHANICVILLE, NY 12118-2124
(518) 664-7336
Mailing address
27 WILLIS AVE, RAVENA, NY 12143-1922
(518) 424-9343
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
792601
NY
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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