Individual
JUSTIN THOMAS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, CRNA, DNP
Contact information
Practice address
701 HEWITT BLVD, RED WING, MN 55066-2848
(651) 267-5000
Mailing address
701 HEWITT BLVD, RED WING, MN 55066-2848
(651) 267-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
196328-5
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
R196328-5
MN
Other
Enumeration date
09/26/2013
Last updated
01/30/2024
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