Provider Demographics
NPI:1568506624
Name:SMITH, SHARON LYNN (RN)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LYNN
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 1:9904 N RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CLAY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48001
Mailing Address - Country:US
Mailing Address - Phone:810-794-1848
Mailing Address - Fax:
Practice Address - Street 1:21885 DUNHAM RD
Practice Address - Street 2:SUITE 2
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-1030
Practice Address - Country:US
Practice Address - Phone:586-783-8113
Practice Address - Fax:586-469-7925
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL672440163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse