Provider Demographics
NPI:1699482901
Name:SMILANSKY, MICHELLE HANNAH (MSN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:HANNAH
Last Name:SMILANSKY
Suffix:
Gender:F
Credentials:MSN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 RIVERBEND DR
Mailing Address - Street 2:
Mailing Address - City:PEGRAM
Mailing Address - State:TN
Mailing Address - Zip Code:37143-2360
Mailing Address - Country:US
Mailing Address - Phone:248-421-1059
Mailing Address - Fax:
Practice Address - Street 1:2265 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2231
Practice Address - Country:US
Practice Address - Phone:212-289-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32838363LW0102X
NY421726363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health