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NPI Code Detail

MEDICARE: MRS. STEPHANIE LYNN SMITH MSN, WHNP-BC

MEDICARE: MRS. STEPHANIE LYNN SMITH MSN, WHNP-BC
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
1363LW0102XWomen's Health Nurse Practitioner4704253301MI
2363LW0102XWomen's Health Nurse PractitionerTPAN2221FL

General Provider Information

NPI Number : 1104153766
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEPHANIE LYNN SMITH MSN, WHNP-BC
Provider Business Mailing Address
First Line : 400 RENAISSANCE CTR STE 2600
Second Line :
City : DETROIT
State : MI
Zip : 48243-1599
Country : US
Telephone Number : 989-277-4077
Fax Number :
Provider Business Practice Location Address
First Line : 400 RENAISSANCE CTR STE 2600
Second Line :
City : DETROIT
State : MI
Zip : 48243-1599
Country : US
Telephone Number : 989-277-4077
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2009
Last Update Date : 11/12/2025

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