Individual
MS. KIMBERLY KAY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(612) 467-4135
Mailing address
3595 BLUE JAY WAY, #102, EAGAN, MN 55123-2443
(651) 905-3675
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9918
MN
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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