Individual
CHANELLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 LORRAINE RD, EAST FALMOUTH, MA 02536-6009
(177) 425-1112
Mailing address
11 LORRAINE RD, EAST FALMOUTH, MA 02536-6009
(774) 251-1125
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN100398
MA
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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