Provider Demographics
NPI:1053105445
Name:SMITH, CHRISTIERRA (LPN)
Entity type:Individual
Prefix:
First Name:CHRISTIERRA
Middle Name:
Last Name:SMITH
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20011 MOUNTVILLE DR
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-1852
Mailing Address - Country:US
Mailing Address - Phone:216-612-8383
Mailing Address - Fax:
Practice Address - Street 1:20011 MOUNTVILLE DR
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-1852
Practice Address - Country:US
Practice Address - Phone:216-612-8383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH187683164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse