Individual
JOY M SMETANKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE
Contact information
Practice address
6939 PINE ARBOR DR S STE 100, COTTAGE GROVE, MN 55016-4643
(651) 326-5800
(651) 326-5802
Mailing address
12912 HIGHCLERE DR, BURNSVILLE, MN 55337-3733
(952) 212-7445
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
1928
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881638054
NPI
MN
05
—
1881638054
—
MN
Enumeration date
06/16/2006
Last updated
05/19/2019
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