Provider Demographics
NPI:1316214760
Name:SMITH, VERONICA RAE ANN (RN, MSN, CNP)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:RAE ANN
Last Name:SMITH
Suffix:
Gender:
Credentials:RN, MSN, CNP
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:RAE ANN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, MSN, CNP
Mailing Address - Street 1:41800 W 11 MILE RD STE 109
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1818
Mailing Address - Country:US
Mailing Address - Phone:248-660-1220
Mailing Address - Fax:
Practice Address - Street 1:2711 RANDOLPH RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2027
Practice Address - Country:US
Practice Address - Phone:704-342-1900
Practice Address - Fax:704-377-0353
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020152363LP2300X
NC5005402364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology