Individual
SARA JEAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1404 COUNTY ROAD C2 W, ROSEVILLE, MN 55113-1631
(651) 353-3593
Mailing address
1404 COUNTY ROAD C2 W, ROSEVILLE, MN 55113-1631
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
818203
MN
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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