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General NPI Number Information
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NPI Number | 1144622168
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Entity Type | Individual
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Provider Name | ELIZABETH LOUISE SMITH APN
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Gender | Female
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Dates
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Enumeration Date | 09/22/2014
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Last Update Date | 08/17/2019
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Provider Practice Location Address
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Address Line | 121 E ASPEN AVE
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City | FRUITA
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State | CO
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Zip | 81521-2543
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Country | US
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Telephone | 970-201-6772
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Fax |
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Provider Business Mailing Address
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Address Line | 121 E ASPEN AVE
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City | FRUITA
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State | CO
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Zip | 81521-2543
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Country | US
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Telephone | 970-201-6772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704273496
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1626779
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 991297
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License Number State | CO
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