Provider Demographics
NPI:1881825248
Name:SMITH CANNON, CHRISTINE MAE (CRNP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MAE
Last Name:SMITH CANNON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 DEERS HEAD HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-3201
Mailing Address - Country:US
Mailing Address - Phone:410-543-4000
Mailing Address - Fax:410-543-4140
Practice Address - Street 1:351 DEERS HEAD HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-3201
Practice Address - Country:US
Practice Address - Phone:410-543-4000
Practice Address - Fax:410-543-4140
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC000697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily