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NPI Code Detail

MEDICARE: KRISTIE PEACE PATTISON SMITH CRNA

MEDICARE: KRISTIE PEACE PATTISON SMITH CRNA
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
1367500000XCertified Registered Nurse AnesthetistAPRN-CRNA150219GA
2163W00000XRegistered NurseR 84401SC

General Provider Information

NPI Number : 1356485726
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIE PEACE PATTISON SMITH CRNA
Provider Business Mailing Address
First Line : PO BOX 204097
Second Line :
City : AUGUSTA
State : GA
Zip : 30917-4097
Country : US
Telephone Number : 706-466-4541
Fax Number : 706-650-1034
Provider Business Practice Location Address
First Line : 3651 WHEELER RD
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-6521
Country : US
Telephone Number : 706-855-9860
Fax Number : 706-860-7124
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2007
Last Update Date : 03/09/2026

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