Individual
MELISSA Y SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
611 W. PARK ST., URBANA, IL 61801-2500
(217) 383-3303
(217) 383-3265
Mailing address
611 W PARK STREET, BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209009022
IL
Other
Enumeration date
11/07/2011
Last updated
06/28/2016
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