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General NPI Number Information
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NPI Number | 1245962893
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Entity Type | Individual
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Provider Name | KRISTEN MICHELE SMITH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 07/10/2022
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Provider Practice Location Address
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Address Line | 708 S 1ST ST
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City | MULESHOE
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State | TX
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Zip | 79347-3627
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Country | US
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Telephone | 806-272-4524
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Fax |
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Provider Business Mailing Address
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Address Line | 6014 14TH ST
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City | LUBBOCK
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State | TX
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Zip | 79416-5106
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Country | US
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Telephone | 806-470-4286
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1085952
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License Number State | TX
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