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General NPI Number Information
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NPI Number | 1467605691
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Entity Type | Organization
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Legal Business Name | KRISTIN N SMITH PLLC
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Dates
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Enumeration Date | 10/31/2008
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 5303 W HACKAMORE DR
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City | PHOENIX
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State | AZ
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Zip | 85083-4418
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Country | US
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Telephone | 623-266-2690
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Fax | 623-337-4224
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Provider Business Mailing Address
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Address Line | 5303 W HACKAMORE DR
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City | PHOENIX
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State | AZ
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Zip | 85083-4418
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Country | US
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Telephone | 623-266-2690
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Fax | 623-337-4224
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Authorized Official
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Title or Position | INDEPENDENT NURSE PRACTITIONER
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Name | KRISTIN NICOLE SMITH
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Credential | ANP-C, RNFA
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Telephone | 602-524-1927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN104595
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License Number State | AZ
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