Healthcare Provider Details

I. General information

NPI: 1982638540
Provider Name (Legal Business Name): MICHELLE LYNN SMITH APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE LYNN SCHRAND

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 2008
CINCINNATI OH
45229-3039
US

IV. Provider business mailing address

3333 BURNET AVE ML 5021
CINCINNATI OH
45229-3039
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-7966
  • Fax: 513-636-7967
Mailing address:
  • Phone: 513-636-4225
  • Fax: 513-636-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN.238006-COA1
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.03920
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: