Individual
PRINCESS MANNY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9564 MONROE ST NE, BLAINE, MN 55434-2539
(763) 732-9142
Mailing address
9564 MONROE ST NE, BLAINE, MN 55434-2539
(763) 732-9142
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2221900
MN
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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