Individual
STEPHANIE ERNESTA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1580 BEAM AVE, MAPLEWOOD, MN 55109-1127
(651) 779-7978
(651) 779-7656
Mailing address
2550 UNIVERSITY AVE W STE 110N, SAINT PAUL, MN 55114-2001
(651) 602-5311
(651) 222-6786
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11653
MN
363A00000X
Physician Assistant
7134-23
WI
Other
Enumeration date
08/04/2014
Last updated
05/23/2025
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