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General NPI Number Information
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NPI Number | 1871465120
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Entity Type | Individual
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Provider Name | KRISTEN SMITH
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Gender | Female
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 1221 GREEN VALLEY DR
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City | SAINT ALBANS
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State | WV
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Zip | 25177-9400
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Country | US
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Telephone | 304-419-9681
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Fax |
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Provider Business Mailing Address
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Address Line | 159 CROCKER PARK BLVD STE 400
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City | WESTLAKE
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State | OH
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Zip | 44145-8147
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Country | US
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Telephone | 513-513-6237
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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