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Individual

STEPHANIE ANN SMART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2198 US 31 S, MANISTEE, MI 49660-9618
(231) 723-3567
Mailing address
6227 FRANKFORT HWY, BENZONIA, MI 49616-8632
(231) 723-3567

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704150277
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4704150277
STATE LICENSE
MI
01
SS150277
3RD PARTY IDENTIFER
MI
Enumeration date
06/06/2006
Last updated
04/16/2013
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