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MARYELLEN T SMITH CPNP
NPI 1225004377
Nurse Practitioner - Pediatrics in St Cloud, MN

Active since February 28, 2006
1900 CENTRACARE CIR #1300, CENTRACARE CLINIC - WOMEN'S AND CHILDRENS, ST CLOUD, MN 56303(320) 654-3610(651) 702-5305 Get Directions Write a Review

NPPES record last updated: September 7, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Maryellen T Smith Cpnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARYELLEN T SMITH CPNP (NPI 1225004377) is an individual pediatrics provider in St Cloud, Minnesota, licensed in Minnesota (R073501-6) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1225004377
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameMARYELLEN T SMITHCredential: CPNP
Location Address1900 CENTRACARE CIR #1300, CENTRACARE CLINIC - WOMEN'S AND CHILDRENSSt Cloud, MN 56303-5000
Mailing Address1900 Centracare Cir #1300, Centracare Clinic - Women's And ChildrensSt Cloud, MN 56303-5000 · (320) 654-3610 · Fax (952) 883-5395
Phone(320) 654-3610
Fax(651) 702-5305
Sole ProprietorNo
Enumeration DateFebruary 28, 2006
Last NPPES UpdateSeptember 7, 2011
✔ NPI 1225004377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in MN · R073501-6
Also ListedNurse PractitionerTaxonomy 363L00000X · License 0735016 (MN)
1900 CENTRACARE CIR #1300, St Cloud, MN 56303
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Other Identifiers 3

Medicare ID-Type Unspecified500001186
Medicaid071742800MN
Medicare UPINP03829

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GERI NEWMAN JACOBSON MD
Pediatrics
1900 CENTRACARE CIR #1300, CENTRA CARE CLINIC WOMEN'S & CHILDRENS
ST CLOUD, MN 56303
Stearns County (320) 654-3610
JILL LYNN AMSBERRY DO
Pediatrics
1900 CENTRACARE CIR #1300, CENTRACARE CLINIC WOMEN'S & CHILDREN'S
ST CLOUD, MN 56303
Stearns County (320) 654-3610

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maryellen Smith's NPI number?

The NPI number for Maryellen Smith is 1225004377. It was assigned to this individual provider in the NPPES registry on February 28, 2006.

Where is Maryellen Smith located?

Maryellen Smith practices at 1900 Centracare Cir #1300 Centracare Clinic - Women's And Childrens, St Cloud, MN 56303. The listed phone number is (320) 654-3610.

What is Maryellen Smith's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Maryellen Smith was last updated on September 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.