Provider Demographics
NPI:1699115899
Name:SMITH, MICHELLE MAUREEN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:MAUREEN
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:MAUREEN
Other - Last Name:LYTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:405 COMMONWEALTH DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN UNIVERSITY
Mailing Address - State:PA
Mailing Address - Zip Code:19352-0406
Mailing Address - Country:US
Mailing Address - Phone:844-883-0071
Mailing Address - Fax:
Practice Address - Street 1:774 CHRISTIANA RD STE 201
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4221
Practice Address - Country:US
Practice Address - Phone:302-366-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant