Michele Lynn Pettit Smith, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

523518 Issued in CA

Practice address

2890 Gateway Oaks Dr Ste 250
Sacramento, CA 95833-4328

Phone

(855) 421-6831

NPI assigned

Aug 24, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Michele Lynn Pettit Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508383290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 GATEWAY OAKS DR STE 250",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958334328",
            "telephone_number": "855-421-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 GATEWAY OAKS DR STE 250",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958334328",
            "telephone_number": "855-421-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHELE",
        "middle_name": "LYNN PETTIT",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "523518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "PETTIT",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Patricia Smith
• Mauresha Denaye' Smith
• Maya Jazmin Smith, MD
• Melissa Kay Smith, D.P.T, A.T.C.
• Micheal Smith, PA
• Michelle Smith, REVEREND
• Miguel Smith
• Monica Smith
• Monika Letitia Smith
• Mya Anne-Marie Smith

• Registered Nurse in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.