Provider Demographics
NPI:1043584667
Name:SMITH, BANFIELD RUEBEN (FNP)
Entity Type:Individual
Prefix:MR
First Name:BANFIELD
Middle Name:RUEBEN
Last Name:SMITH
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14613 E ATLANTIC DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1513
Mailing Address - Country:US
Mailing Address - Phone:720-324-8028
Mailing Address - Fax:720-532-0372
Practice Address - Street 1:14613 E ATLANTIC DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1513
Practice Address - Country:US
Practice Address - Phone:303-755-1566
Practice Address - Fax:303-484-6300
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily