Individual
MISS NICOLE LEEANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
500 COLUMBIA RD, DORCHESTER, MA 02125-2322
(617) 287-8000
Mailing address
590 MIDDLE ST APT 406, WEYMOUTH, MA 02189-1113
(857) 236-5086
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN96022
MA
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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