Healthcare Provider Details

I. General information

NPI: 1720923576
Provider Name (Legal Business Name): ALEXANDRA MARY SMITH WINSHIP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRA SMITH

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 RAILROAD ST SE
PINE CITY MN
55063-1540
US

IV. Provider business mailing address

529 OLD MAIN ST N
CAMBRIDGE MN
55008-1162
US

V. Phone/Fax

Practice location:
  • Phone: 651-213-2569
  • Fax: 651-925-0071
Mailing address:
  • Phone: 651-213-2569
  • Fax: 651-925-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32720
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: