Provider Demographics
NPI:1700174588
Name:TERRI EILENE LIGHT
Entity Type:Organization
Organization Name:TERRI EILENE LIGHT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:EILENE
Authorized Official - Last Name:LIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BC
Authorized Official - Phone:303-973-9439
Mailing Address - Street 1:9235 W HINSDALE PL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4165
Mailing Address - Country:US
Mailing Address - Phone:303-973-9439
Mailing Address - Fax:
Practice Address - Street 1:9235 W HINSDALE PL
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-4165
Practice Address - Country:US
Practice Address - Phone:303-973-9439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO61699273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit