Individual
JENNIFER LYNN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
6445 RICHFIELD PKWY, RICHFIELD, MN 55423-6400
(866) 389-2727
Mailing address
6445 RICHFIELD PKWY, RICHFIELD, MN 55423-6400
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9950
MN
363A00000X
Physician Assistant
9952
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504193700
—
MN
Enumeration date
09/09/2005
Last updated
04/23/2025
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