| NPI | 1194357749 |
|---|---|
| Former Name | KRISTEN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 7964749-4409) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: UT 7964749-3102) |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-04-08 |