Healthcare Provider Details

I. General information

NPI: 1891766416
Provider Name (Legal Business Name): CHRISTINE LEE SMITH R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S 1000 W
TOOELE UT
84074-4010
US

IV. Provider business mailing address

915 W 1220 S
TOOELE UT
84074-9514
US

V. Phone/Fax

Practice location:
  • Phone: 435-843-3520
  • Fax:
Mailing address:
  • Phone: 435-882-1690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number267457-3102
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number267457-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: