Provider Demographics
NPI:1790831519
Name:SMITH, CHRISTINE BENZ (ANP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:BENZ
Last Name:SMITH
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 EDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-2401
Mailing Address - Country:US
Mailing Address - Phone:423-265-0888
Mailing Address - Fax:
Practice Address - Street 1:501 HOUSTON ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-3409
Practice Address - Country:US
Practice Address - Phone:423-425-4453
Practice Address - Fax:425-425-2266
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5368363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5368OtherADVANCED PRACTICE NURSE
TN42982OtherNURSE PRACTIONER