Individual
ANNA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082-6040
(651) 439-1234
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12254
MN
Other
Enumeration date
11/14/2016
Last updated
11/26/2019
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