Provider Demographics
NPI:1083487136
Name:SMITH, CHRISTINE YVONNE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:YVONNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1843 MERIBROOK RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2014
Mailing Address - Country:US
Mailing Address - Phone:302-765-8469
Mailing Address - Fax:
Practice Address - Street 1:1503 LANSDOWNE AVE STE 3002
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1308
Practice Address - Country:US
Practice Address - Phone:610-237-4995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028478363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily