Individual
MATTHEW LYNN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, BSN, MS, CRNA
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
Mailing address
2194 N 850 W, CLINTON, UT 84015-6700
(801) 779-2985
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R31701
ND
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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