Individual
COURTNEY J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1885 PLAZA DR, EAGAN, MN 55122-2979
(952) 993-4069
(952) 993-4095
Mailing address
1885 PLAZA DR, EAGAN, MN 55122-2979
(952) 993-4069
(952) 993-4095
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10170
MN
Other
Enumeration date
09/07/2006
Last updated
02/28/2020
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