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NPI Code Detail

MEDICARE: MRS. CHRISTINE LORRAINE SMITH NCMMT, LMT

MEDICARE: MRS. CHRISTINE LORRAINE SMITH NCMMT, LMT
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
1174400000XSpecialist
2376K00000XNurse's AideNA00769155CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1130409OTHERCOCITY LICENSE

General Provider Information

NPI Number : 1861526147
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINE LORRAINE SMITH NCMMT, LMT
Provider Business Mailing Address
First Line : 4334 CASSIDY STREET
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80911
Country : US
Telephone Number : 719-205-6647
Fax Number :
Provider Business Practice Location Address
First Line : 4334 CASSIDY STREET
Second Line : #109
City : COLORADO SPRINGS
State : CO
Zip : 80911-3203
Country : US
Telephone Number : 719-471-2755
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 12/31/2019

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