Provider Demographics
NPI:1255640470
Name:COLWELL, SMYTH T
Entity type:Individual
Prefix:
First Name:SMYTH
Middle Name:T
Last Name:COLWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5660 S LANSING WAY
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4106
Mailing Address - Country:US
Mailing Address - Phone:303-550-3220
Mailing Address - Fax:
Practice Address - Street 1:5660 S LANSING WAY
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-4106
Practice Address - Country:US
Practice Address - Phone:303-550-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO195341163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse