Individual
MS. CARRIE SUSAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
333 WASHINGTON AVE N, SUITE 5000, MINNEAPOLIS, MN 55401-1377
(763) 712-5974
Mailing address
13176 MARIGOLD ST NW, COON RAPIDS, MN 55448-1089
(763) 712-5695
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R160154-7
MN
363LF0000X
Family Nurse Practitioner
Primary
1050
MN
Other
Enumeration date
09/12/2005
Last updated
11/09/2020
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