Healthcare Provider Details

I. General information

NPI: 1528182300
Provider Name (Legal Business Name): KRISTIN PAIGE SMITH PT, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KENNEDY DR STE L8
SOUTH BURLINGTON VT
05403-7165
US

IV. Provider business mailing address

30 ARLINGTON GRN
SOUTH BURLINGTON VT
05403-7001
US

V. Phone/Fax

Practice location:
  • Phone: 802-863-2013
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number867109
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number000-0002562
License Number StateVT
# 4
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: