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General NPI Number Information
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NPI Number | 1861526147
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Entity Type | Individual
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Provider Name | CHRISTINE LORRAINE SMITH NCMMT, LMT
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Gender | Female
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 12/31/2019
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Provider Practice Location Address
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Address Line | 4334 CASSIDY STREET #109
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City | COLORADO SPRINGS
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State | CO
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Zip | 80911-3203
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Country | US
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Telephone | 719-471-2755
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Fax |
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Provider Business Mailing Address
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Address Line | 4334 CASSIDY STREET
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City | COLORADO SPRINGS
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State | CO
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Zip | 80911
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Country | US
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Telephone | 719-205-6647
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | NA00769155
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License Number State | CO
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