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Individual

MS. KRISTEN DIANE SMITH

Active
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Individual

MS. KRISTEN DIANE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01096117A
IN
208000000X
Pediatrics Physician
Primary
125-055924
IL
208M00000X
Hospitalist Physician
01096117A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036130223
IL
Enumeration date
09/28/2009
Last updated
05/16/2025
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