Provider Demographics
NPI:1043796808
Name:SMITH, CHRISTINA JEANETTE (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JEANETTE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:JEANETTE
Other - Last Name:WILKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:6155 SOUTH GRAND BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63111-2319
Mailing Address - Country:US
Mailing Address - Phone:314-274-6856
Mailing Address - Fax:866-892-0756
Practice Address - Street 1:6155 SOUTH GRAND BLVD
Practice Address - Street 2:STE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63111-2319
Practice Address - Country:US
Practice Address - Phone:314-274-6856
Practice Address - Fax:866-892-0756
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051298059183500000X
MO2014029962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist