Individual
MRS. JODIE MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, FNP-BC
Contact information
Practice address
2200 NW 26TH ST, OWATONNA, MN 55060-5503
(507) 451-1120
Mailing address
3908 W 53RD ST, ROELAND PARK, KS 66205-2452
(913) 400-3831
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13-101356-062
KS
163W00000X
Registered Nurse
2009027212
MO
163W00000X
Registered Nurse
204416-1
MN
363LF0000X
Family Nurse Practitioner
Primary
204416-1
MN
Other
Enumeration date
10/17/2011
Last updated
01/07/2021
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