Provider Demographics
NPI:1386613487
Name:SMITH, CHRISTINA L (CRNA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-2803
Mailing Address - Country:US
Mailing Address - Phone:712-243-2866
Mailing Address - Fax:
Practice Address - Street 1:CREIGHTON UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:601 NORTH 30TH STREET
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131
Practice Address - Country:US
Practice Address - Phone:402-449-4847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100966367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered