Provider Demographics
NPI:1710758792
Name:SMITH, JOI RENEE' (RN)
Entity Type:Individual
Prefix:MISS
First Name:JOI
Middle Name:RENEE'
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 WEDDEL ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-2627
Mailing Address - Country:US
Mailing Address - Phone:313-720-1934
Mailing Address - Fax:
Practice Address - Street 1:7220 WEDDEL ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-2627
Practice Address - Country:US
Practice Address - Phone:313-720-1934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704302295163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine