Provider Demographics
NPI:1669021580
Name:SMITH, CHRISTOPHER LYNN (APRN-CNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:M
Credentials:APRN-CNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 JEWEL LAKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-5337
Mailing Address - Country:US
Mailing Address - Phone:907-248-8561
Mailing Address - Fax:907-248-8563
Practice Address - Street 1:9150 JEWEL LAKE RD STE B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-5337
Practice Address - Country:US
Practice Address - Phone:907-248-8561
Practice Address - Fax:907-248-8563
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK224298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily