Provider Demographics
NPI:1457395154
Name:SMITH, CHRISTINE L (MSN, FNP-PP, CRNFA)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSN, FNP-PP, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 PENN LN
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1528
Mailing Address - Country:US
Mailing Address - Phone:503-655-7725
Mailing Address - Fax:503-655-7720
Practice Address - Street 1:1713 PENN LANE
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045
Practice Address - Country:US
Practice Address - Phone:503-655-7725
Practice Address - Fax:503-655-7720
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200950122NP FNP-PP363LF0000X
OR093000434RN163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR200950122NP FNP-PPOtherNP LICENSE
OR093000434RNOtherOREGON BOARD OF NURSIN