Most Relevant Information
Provider Data
| NPI Number: | 1003387655 |
| Provider Name: | VANESSA RAE SMITKO NP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 4704257394 |
Most Important Dates
| Enumeration Date: | 12/07/2018 |
| Last Updated: | 11/05/2024 |
Provider Practice Location
2770 E BELTLINE AVE NE
GRAND RAPIDS
MI
495258614
Practice Location Phone/Fax
| Phone: | 6162678860 |
| Fax: |
Provider Mailing Location
100 MICHIGAN ST NE # MC845
GRAND RAPIDS
MI
495032560
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |