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NPI Code Detail

MEDICARE: WHITNEY LANEE SMITH FNP-C

MEDICARE:   WHITNEY LANEE SMITH  FNP-C
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
1363LF0000XFamily Nurse Practitioner4704342768MI

General Provider Information

NPI Number : 1710749254
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY LANEE SMITH FNP-C
Provider Business Mailing Address
First Line : PO BOX 746723
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6723
Country : US
Telephone Number : 312-733-9730
Fax Number :
Provider Business Practice Location Address
First Line : 26390 GRATIOT AVE
Second Line :
City : ROSEVILLE
State : MI
Zip : 48066-5106
Country : US
Telephone Number : 586-221-7020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2024
Last Update Date : 06/04/2026

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Directions to “ WHITNEY LANEE SMITH FNP-C” Practice Location

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