Provider Demographics
NPI:1457714255
Name:SMITH, YADHIRA (RN)
Entity Type:Individual
Prefix:
First Name:YADHIRA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7290 SAMUEL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80221-2790
Mailing Address - Country:US
Mailing Address - Phone:720-471-4560
Mailing Address - Fax:
Practice Address - Street 1:7290 SAMUEL DR STE 300
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80221-2790
Practice Address - Country:US
Practice Address - Phone:720-471-4560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1634559163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse