Provider Demographics
NPI:1689913006
Name:SMITH, KRISTIN LEE
Entity Type:Individual
Prefix:MISS
First Name:KRISTIN
Middle Name:LEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 PITMAN RD
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-1956
Mailing Address - Country:US
Mailing Address - Phone:978-413-8316
Mailing Address - Fax:
Practice Address - Street 1:102 PITMAN RD
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-1956
Practice Address - Country:US
Practice Address - Phone:978-413-8316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula