Provider Demographics
NPI:1841765344
Name:CLARK, RIANNE (FNP)
Entity Type:Individual
Prefix:
First Name:RIANNE
Middle Name:
Last Name:CLARK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:RIANNE
Other - Middle Name:
Other - Last Name:SMEELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1805 SHEA CENTER DR STE 450
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2255
Mailing Address - Country:US
Mailing Address - Phone:303-357-2551
Mailing Address - Fax:303-221-2445
Practice Address - Street 1:8200 E BELLEVIEW AVE STE 202
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2805
Practice Address - Country:US
Practice Address - Phone:303-357-2551
Practice Address - Fax:303-221-2445
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993967-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner