Provider Demographics
NPI:1235954843
Name:SMITH, MICHAEL FRANCIS (RN)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:FRANCIS
Last Name:SMITH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 W KEIM DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1526
Mailing Address - Country:US
Mailing Address - Phone:602-334-0825
Mailing Address - Fax:
Practice Address - Street 1:2010 W KEIM DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1526
Practice Address - Country:US
Practice Address - Phone:602-334-0825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN173482163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse