Provider Demographics
NPI:1841308046
Name:SMITH, CHRISTINE SUE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:SUE
Last Name:SMITH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29199 LIVINGSTON DR
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33982-1212
Mailing Address - Country:US
Mailing Address - Phone:941-235-2710
Mailing Address - Fax:941-235-2712
Practice Address - Street 1:29199 LIVINGSTON DR
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33982-1212
Practice Address - Country:US
Practice Address - Phone:941-235-2710
Practice Address - Fax:941-235-2712
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2014412363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner