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NPI Code Detail

MEDICARE: KRISTY M SMITH

MEDICARE: KRISTY M 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
1376J00000XHomemakerFL

General Provider Information

NPI Number : 1861285678
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTY M SMITH
Provider Business Mailing Address
First Line : 1248 EDGEWOOD AVE W STE 3
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32208-2874
Country : US
Telephone Number : 904-575-6094
Fax Number :
Provider Business Practice Location Address
First Line : 1248 EDGEWOOD AVE W STE 3
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32208-2874
Country : US
Telephone Number : 904-575-6094
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2025
Last Update Date : 05/24/2025

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Directions to “ KRISTY M SMITH ” Practice Location

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