Provider Demographics
NPI:1780138354
Name:SMOLIK, SHAINA KRISTIE (NP)
Entity type:Individual
Prefix:MRS
First Name:SHAINA
Middle Name:KRISTIE
Last Name:SMOLIK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHAINA
Other - Middle Name:KRISTIE
Other - Last Name:VACZY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 FORBES RD STE 400
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-2715
Mailing Address - Country:US
Mailing Address - Phone:617-322-2694
Mailing Address - Fax:
Practice Address - Street 1:220 FORBES RD STE 400
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2715
Practice Address - Country:US
Practice Address - Phone:617-322-2694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2299260363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics