MEDICARE: BRANDI MICHELLE SMITH FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0029117	OH

General Provider Information

NPI Number	:	1114596954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI MICHELLE SMITH FNP-C

Provider Business Mailing Address
First Line	:	3950 SUNFOREST CT STE 101
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-4522
Country	:	US
Telephone Number	:	419-465-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	3950 SUNFOREST CT STE 101
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-4522
Country	:	US
Telephone Number	:	419-465-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2021
Last Update Date	:	07/31/2024

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