Individual
KRISTINE M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(478) 538-0838
Mailing address
255 BEACON HL, MACON, GA 31210-2103
(478) 284-9052
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN157400
GA
Other
Enumeration date
02/21/2011
Last updated
07/01/2020
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