Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | CNP 4052 | MN |
NPI | 1093191082 |
---|---|
Provider Name | Akia M Smith |
First Address | Saint Paul, MN 55114-2001 |
Second Address | Coon Rapids, MN 55433-2774 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2015 |
Last Update Date | 18/12/2018 |