Doctor Name: | STEPHANIE SMITH |
NPI Number: | 1639467400 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 304 Johnson Ave N Fosston, MN - 565421318 |
Business Phone Number: | 2184351264 |
Business Fax Number: | |
Mailing Address: | 304 Johnson Ave N, FOSSTON |
State: | MN |
Postal Code: | 565421318 |
Phone Number: | 2184351264 |
Fax Number: | |
NPI Enumeration Date: | 07/14/2011 |
NPI Last Update Date: | 07/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 172A00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Driver |
Taxonomy Specialization: | |
Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |