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General NPI Number Information
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NPI Number | 1326642893
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Entity Type | Individual
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Provider Name | KRISTIN LERESA SMITH PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/25/2020
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | 19215 N 3RD ST
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City | CITRONELLE
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State | AL
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Zip | 36522-4017
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Country | US
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Telephone | 251-866-9605
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Fax | 251-866-9416
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Provider Business Mailing Address
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Address Line | 19215 N 3RD ST
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City | CITRONELLE
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State | AL
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Zip | 36522-4017
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Country | US
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Telephone | 251-866-9605
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Fax | 251-866-9416
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17085
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License Number State | AL
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