ANGELA JUSTINE SMITH NP-C NPI 1225585177

NPI Information

NPI: 1225585177
Provider Name: ANGELA JUSTINE SMITH, NP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
4801 VETERANS DR
SAINT CLOUD, MN
ZIP 56303
Phone: (320) 252-1670
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Angela Justine Smith, NP-C is a family nurse practitioner in Saint Cloud, MN. Angela Justine Smith, NP-C NPI is 1225585177. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4801 VETERANS DR
SAINT CLOUD, MN
ZIP 56303-015
Phone: (320) 252-1670

The NPI 1225585177 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 9/8/2016 and was last updated on 10/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	CNP4579	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MS3993676	OTHER	MINNESOTA	DEA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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