MEDICARE: KRISTIN SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS66156	FL
2	183500000X	Pharmacist	024121	KY

General Provider Information

NPI Number	:	1073396628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN SMITH

Provider Business Mailing Address
First Line	:	3855 FOUNTAINBLUE LN
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40513-8310
Country	:	US
Telephone Number	:	859-469-7338
Fax Number	:

Provider Business Practice Location Address
First Line	:	3855 FOUNTAINBLUE LN
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40513-8310
Country	:	US
Telephone Number	:	859-469-7338
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2023
Last Update Date	:	05/26/2026

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Directions to “ KRISTIN SMITH ” Practice Location

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