Princess Manny Smith

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2221900 Issued in MN

Practice address

9564 Monroe St NE
Blaine, MN 55434-2539

Phone

(763) 732-9142

NPI assigned

Dec 18, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serenehands Home Health Care Inc.

  • Home Health Agency
  • Blaine, MN
  • NPI 1033686233
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1114433885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9564 MONROE ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554342539",
            "telephone_number": "763-732-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9564 MONROE ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554342539",
            "telephone_number": "763-732-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PRINCESS",
        "middle_name": "MANNY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2221900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Marie Sis, OD, MS, FAAO
• Sisters Supportive Living LLC
• Stephen Sitrin, M.D.
• Skills Enrichment Services Inc
• Amanda Smith, DC
• Jonathan Raphael Snitzer, MD
• Snyders Drug (Snyder Drug Emporium)
• Trang Thi Thuy Son
• Soul Work Counseling, LLC
• Jennifer Soular

• Registered Nurse in Blaine, MN
• Providers in Blaine, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.