Healthcare Provider Details

I. General information

NPI: 1043802234
Provider Name (Legal Business Name): REBECCA FAITH SMITH-MINGUS DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 3RD AVE FL 9
NEW YORK NY
10017-4151
US

IV. Provider business mailing address

685 3RD AVE FL 9
NEW YORK NY
10017-4151
US

V. Phone/Fax

Practice location:
  • Phone: 314-720-1644
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61261585
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: