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General NPI Number Information
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NPI Number | 1669450748
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Entity Type | Individual
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Provider Name | DANIELLE MICHEL SMITH NP
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Gender | Female
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 09/21/2017
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Provider Practice Location Address
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Address Line | 18101 OAKWOOD BLVD ISU-OBS
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City | DEARBORN
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State | MI
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Zip | 48123-4089
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Country | US
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Telephone | 313-982-5770
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Fax | 313-982-5771
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Provider Business Mailing Address
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Address Line | 23300 ECORSE RD
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City | TAYLOR
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State | MI
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Zip | 48180-1768
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Country | US
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Telephone | 313-291-9500
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Fax | 313-291-6694
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704194031
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License Number State | MI
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