Provider Demographics
NPI:1275847956
Name:SMITH, RENEE LOUISE (NP)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:LOUISE
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7780 S BROADWAY
Mailing Address - Street 2:#300
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2648
Mailing Address - Country:US
Mailing Address - Phone:303-955-7574
Mailing Address - Fax:720-242-9307
Practice Address - Street 1:7780 S BROADWAY
Practice Address - Street 2:#300
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2648
Practice Address - Country:US
Practice Address - Phone:303-955-7574
Practice Address - Fax:720-242-9307
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONP10316363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner