Individual provider · NPI-1

Kristina D Adams Smith, RD

Dietitian, Registered · Mattoon, IL

NPI number1972622512
StatusActive
Last updated in NPPESMar 26, 2013

Details

NPI
1972622512
Entity type
Individual (NPI-1)
Name
Kristina D Adams Smith
Credential
RD
Sex
Female
Sole proprietor
No
Enumeration date
Mar 28, 2007
Last updated
Mar 26, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered164.003450ILYes

Practice location

1005 Health Center Drive
Suite 101
Mattoon, IL 61938

Phone 217-238-4774 · Fax 217-238-4775

Mailing address

1005 Health Center Drive
Suite 101
Mattoon, IL 61938

Phone 217-238-4774 · Fax 217-238-4775

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