Provider Demographics
NPI:1447072285
Name:SMITH, CHRISTIN (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 W BROWNING RD APT 9A
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1134
Mailing Address - Country:US
Mailing Address - Phone:609-234-5005
Mailing Address - Fax:
Practice Address - Street 1:9 W BROWNING RD APT 9A
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-1134
Practice Address - Country:US
Practice Address - Phone:609-234-5005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15191200363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health