Healthcare Provider Details

I. General information

NPI: 1386073591
Provider Name (Legal Business Name): MICHELLE SMITH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 E PARKS HWY
WASILLA AK
99654-8283
US

IV. Provider business mailing address

2601 E HIAWATHA DR
WASILLA AK
99654-2853
US

V. Phone/Fax

Practice location:
  • Phone: 907-352-5033
  • Fax:
Mailing address:
  • Phone: 907-352-5033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2205
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: