Individual provider · Type 1 NPI

Stephanie Dora Smith, NP

Gerontology Nurse Practitioner · Grand Rapids, MI

NPI number 1417208463 Active

Practice location

275 Michigan St NE
Grand Rapids, MI 49503-2531

Mailing address

100 Michigan St NE # MC845
Grand Rapids, MI 49503-2560

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600X4704272685 (MI)
Adult Health Nurse Practitioner 363LA2200X4704272685 (MI)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1417208463

Stephanie Dora Smith, NP's National Provider Identifier is 1417208463, issued on Sep 29, 2012. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Grand Rapids, MI. The record was last updated on Jan 29, 2025.