Healthcare Provider Details

I. General information

NPI: 1780950741
Provider Name (Legal Business Name): CHRISTOPHER G. SMITH RNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2012
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 WATER ST
BLUE HILL ME
04614
US

IV. Provider business mailing address

57 WATER STREET
BLUE HILL ME
04614
US

V. Phone/Fax

Practice location:
  • Phone: 207-374-3400
  • Fax:
Mailing address:
  • Phone: 207-374-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN36854
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: