Dr. Kevin Lee Smith, DNP
Nurse Practitioner, Family in Minneapolis, MN. Individual provider (NPI-1).
NPI number1679531024
StatusActive
Last updated in NPPESJun 30, 2021
Details
- NPI
- 1679531024
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kevin Lee Smith
- Credential
- DNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 3, 2006
- Certification date
- Jun 30, 2021
- Last updated
- Jun 30, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | R096446-3 | MN | Yes |
Practice location
6655 Cortlawn Cir SMinneapolis, MN 55426-1557
Phone 763-639-5327
Mailing address
18510 25th Ave NPlymouth, MN 55447-2016
Phone 763-639-5327
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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