Provider Demographics
NPI:1770336190
Name:SMITH, DANIELLE ELIZABETH
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7243 KENT ST
Mailing Address - Street 2:
Mailing Address - City:FREDERIC
Mailing Address - State:MI
Mailing Address - Zip Code:49733-9755
Mailing Address - Country:US
Mailing Address - Phone:989-889-1588
Mailing Address - Fax:
Practice Address - Street 1:7243 KENT ST
Practice Address - Street 2:
Practice Address - City:FREDERIC
Practice Address - State:MI
Practice Address - Zip Code:49733-9755
Practice Address - Country:US
Practice Address - Phone:989-889-1588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide