Provider Demographics
NPI:1851988638
Name:SMITH, CHRISTIE DENISE
Entity Type:Individual
Prefix:MS
First Name:CHRISTIE
Middle Name:DENISE
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 1:1567 COLTON ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-2115
Mailing Address - Country:US
Mailing Address - Phone:419-461-2768
Mailing Address - Fax:
Practice Address - Street 1:2016 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-1607
Practice Address - Country:US
Practice Address - Phone:419-461-2768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health Aide