Provider Demographics
NPI:1346431632
Name:SMITH, KRISTEN ALAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:ALAINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:35040 CHARDON RD STE 110
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094-9004
Mailing Address - Country:US
Mailing Address - Phone:440-946-1200
Mailing Address - Fax:440-946-5186
Practice Address - Street 1:35040 CHARDON RD STE 110
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-9004
Practice Address - Country:US
Practice Address - Phone:440-946-1200
Practice Address - Fax:440-946-5186
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.0119312084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology