Provider Demographics
NPI:1952738213
Name:SMITH, GAIL ANN (CNA)
Entity Type:Individual
Prefix:MISS
First Name:GAIL
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SUNFLOWER RD.
Mailing Address - Street 2:#120
Mailing Address - City:COLO. SPGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907
Mailing Address - Country:US
Mailing Address - Phone:719-632-5269
Mailing Address - Fax:
Practice Address - Street 1:85 SUNFLOWER RD.
Practice Address - Street 2:#120
Practice Address - City:COLO. SPGS
Practice Address - State:CO
Practice Address - Zip Code:80907
Practice Address - Country:US
Practice Address - Phone:719-632-5269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO516679374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide