Individual
KRISTINE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3723 FRANKLIN ST, MICHIGAN CITY, IN 46360-7310
(219) 874-3313
(219) 878-2330
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.022808
IL
363L00000X
Nurse Practitioner
F346395-01
NY
363LF0000X
Family Nurse Practitioner
28271741A
IN
363LF0000X
Family Nurse Practitioner
Primary
71012268A
IN
Other
Enumeration date
06/07/2021
Last updated
09/14/2023
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