Individual ProviderSarah K.L. SmithNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664(801) 800-2894PECOS EnrollmentBased on the most recent information from CMS, provider Sarah K.L. Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1700802279Provider TypeIndividualFull NameSmith, Sarah K.L.CredentialNPGenderFemaleSole ProprietorNoEnumeration Date7/15/2006Last Updated8/24/2020Contact InformationPractice LocationPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664Phone(801) 800-2894FaxUnlisted FaxMailing LocationMailing Address10808 N Highland Cir, Highland, UT 84003-9020Phone(801) 800-2894FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense5291605-4405UtahProvider IdentifiersIDDescriptionIssuerID52916054400001DescriptionOtherIssuerBCBS OF UTAHUtahIDP00304489DescriptionOtherIssuerPALMETTOUtah