MEDICARE: MRS. STEPHANIE ELAINE ANDERSON-SMITH DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4294	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	HP47384	OTHER	MN	HEALTH PARTNERS
3	322J7AN	OTHER	MN	BCBS

General Provider Information

NPI Number	:	1538168687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE ELAINE ANDERSON-SMITH DC

Provider Business Mailing Address
First Line	:	12 2ND AVE S
Second Line	:
City	:	SAUK RAPIDS
State	:	MN
Zip	:	56379-1408
Country	:	US
Telephone Number	:	320-257-6008
Fax Number	:	320-257-6009

Provider Business Practice Location Address
First Line	:	12 2ND AVE S
Second Line	:
City	:	SAUK RAPIDS
State	:	MN
Zip	:	56379-1408
Country	:	US
Telephone Number	:	320-257-6008
Fax Number	:	320-257-6009

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	12/30/2024

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