Individual
FALLEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
18425 WESTPHALIA ST, DETROIT, MI 48205-2642
(313) 399-6158
Mailing address
18425 WESTPHALIA ST, DETROIT, MI 48205-2642
(313) 399-6158
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
470390485
MI
163W00000X
Registered Nurse
4704390485
MI
Other
Enumeration date
06/29/2023
Last updated
06/29/2023
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