Individual
RENIE L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OGNP
Contact information
Practice address
2805 DODD RD STE 100, EAGAN, MN 55121-2160
(651) 241-7733
(651) 241-0258
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3745
MN
363LW0102X
Women's Health Nurse Practitioner
R 125516-8
MN
Other
Enumeration date
04/26/2006
Last updated
04/30/2018
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