Provider Demographics
NPI:1053814954
Name:SMITH, NATALIA (FNP, AGACNP)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP, AGACNP
Other - Prefix:
Other - First Name:NATALIA
Other - Middle Name:
Other - Last Name:MENERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP, AGACNP
Mailing Address - Street 1:2010 16TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-5188
Mailing Address - Country:US
Mailing Address - Phone:970-820-2120
Mailing Address - Fax:
Practice Address - Street 1:2010 16TH ST STE A
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-5188
Practice Address - Country:US
Practice Address - Phone:970-820-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993599-NP363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty