Healthcare Provider Details

I. General information

NPI: 1982509246
Provider Name (Legal Business Name): KRISTYN MARIE D'ANGELO SMITH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 IPSWICH DR
WILMINGTON DE
19808-3031
US

IV. Provider business mailing address

1221 IPSWICH DR
WILMINGTON DE
19808-3031
US

V. Phone/Fax

Practice location:
  • Phone: 610-721-9943
  • Fax:
Mailing address:
  • Phone: 610-721-9943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberL1-0035616
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: