MEDICARE: JENNA SMITH

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	2251P0200X	Pediatric Physical Therapist	8899	MN

General Provider Information

NPI Number	:	1770426678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA SMITH

Provider Business Mailing Address
First Line	:	11700 10TH ST SE
Second Line	:
City	:	EYOTA
State	:	MN
Zip	:	55934-2332
Country	:	US
Telephone Number	:	612-226-2858
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 PINEWOOD RD SE
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55904-5833
Country	:	US
Telephone Number	:	507-328-4900
Fax Number	:

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

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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Directions to “ JENNA SMITH ” Practice Location

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