Warren Smith, Jacquelyn

Warren Smith, Jacquelyn is an individual health care provider with primary practice located at 2480 W Campus Dr Ste 500, Mt Pleasant MI 48858-5414. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Warren Smith, Jacquelyn can be contacted via phone (989) 772-1609.

Contact Information

Primary practice address
2480 W Campus Dr Ste 500 Mt Pleasant MI 48858-5414
Phone: (989) 772-1609
Fax: (989) 773-6279
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704111871 Michigan

Profile Details

NPI number 1669596565
LBN Legal business name Warren Smith, Jacquelyn
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2007
Last updated Aug 19th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669596565 NPPES
Michigan MEDICAID 1174698336

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