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General NPI Number Information
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NPI Number | 1184999179
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Entity Type | Individual
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Provider Name | MICHELLE RENEE SMITH WHNP
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Gender | Female
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Dates
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Enumeration Date | 03/09/2012
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 4216 HILLS AND DALES RD NW
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City | CANTON
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State | OH
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Zip | 44708-1658
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Country | US
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Telephone | 330-617-5785
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 87
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City | MIDDLEBRANCH
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State | OH
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Zip | 44652-0087
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 376684
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN376684
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APRN.CNP.14081
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License Number State | OH
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