| Doctor Name: | MRS. KRISTIN LEE GOLLEY-SMITH |
| NPI Number: | 1164811899 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 694077-1 |
| Business Practice Address: | 201 Hanson Rd Mexico, NY - 131144252 |
| Business Phone Number: | 3158870201 |
| Business Fax Number: | |
| Mailing Address: | 201 Hanson Rd, MEXICO |
| State: | NY |
| Postal Code: | 131144252 |
| Phone Number: | 3159970201 |
| Fax Number: | |
| NPI Enumeration Date: | 01/19/2015 |
| NPI Last Update Date: | 01/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 694077-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |