Individual
KRISTINA NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,FNP-C
Contact information
Practice address
1201 WOODDELL WAY STE B, MATTOON, IL 61938-1014
(217) 238-3000
(217) 238-3008
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209019250
IL
Other
Enumeration date
08/26/2019
Last updated
11/05/2024
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