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General NPI Number Information
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NPI Number | 1851820773
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Entity Type | Individual
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Provider Name | JUSTIN MICHAEL SMITH DNP
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Gender | Male
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 1617 E DIVISION ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-1571
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Country | US
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Telephone | 715-307-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 CHICAGO AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-1321
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Country | US
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Telephone | 612-262-9000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 185099
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 202207051
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R-212530-7
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | W164201
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License Number State | IA
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Taxonomy #5
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 202207448CNS-PP
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 974938
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11108
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License Number State | MN
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 356671
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License Number State | NY
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Taxonomy #9
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 7951-33
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License Number State | WI
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Taxonomy #10
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 2022030124
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License Number State | MO
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Taxonomy #11
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | AP61288318
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License Number State | WA
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Taxonomy #12
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 7951-33
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License Number State | WI
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Taxonomy #13
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 283150
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License Number State | AZ
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Taxonomy #14
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 538
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License Number State | MN
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