Individual
MR. CHRISTOPHER LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, PMHNP-BC
Contact information
Practice address
409 W 400 S, THE FOURTH STREET CLINIC, SALT LAKE CITY, UT 84101
(385) 234-5705
(801) 364-0161
Mailing address
409 W 400 S, THE FOURTH STREET CLINIC, SALT LAKE CITY, UT 84101
(385) 234-5705
(801) 364-0161
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
65978714405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6597871-4405
UT
Other
Enumeration date
02/04/2016
Last updated
11/04/2022
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