Provider Demographics
NPI: | 1710715263 |
---|---|
Name: | SMITH, CHRISTOPHER (APRN, NNP-BC) |
Entity type: | Individual |
Prefix: | |
First Name: | CHRISTOPHER |
Middle Name: | |
Last Name: | SMITH |
Suffix: | |
Gender: | M |
Credentials: | APRN, NNP-BC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 106 BARLEY BARN CT |
Mailing Address - Street 2: | |
Mailing Address - City: | GREENVILLE |
Mailing Address - State: | SC |
Mailing Address - Zip Code: | 29607-6055 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 231-620-8277 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 509 BILTMORE AVE |
Practice Address - Street 2: | |
Practice Address - City: | ASHEVILLE |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28801-4601 |
Practice Address - Country: | US |
Practice Address - Phone: | 828-776-6126 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2024-07-25 |
Last Update Date: | 2025-08-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
SC | 262487 | 163WN0002X |
NC | 0000000 | 363LN0000X |
NC | 5020523 | 363L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 163WN0002X | Nursing Service Providers | Registered Nurse | Neonatal Intensive Care |
No | 363LN0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal |