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NPI Code Detail

MEDICARE: MISS PHYLLIS LORRAINE SMITH RN

MEDICARE: MISS PHYLLIS LORRAINE SMITH RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WH0200XHome Health Registered Nurse123597CO
2163WM0102XMaternal Newborn Registered Nurse123597CO
3163WP1700XPerinatal Registered Nurse123597CO
4163WX0002XHigh-Risk Obstetric Registered Nurse123597CO
5163WX0003XInpatient Obstetric Registered Nurse123597CO

General Provider Information

NPI Number : 1841470150
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS PHYLLIS LORRAINE SMITH RN
Provider Business Mailing Address
First Line : 6024 S MEADOW LARK PL
Second Line :
City : CASTLE ROCK
State : CO
Zip : 80109-2842
Country : US
Telephone Number : 303-660-1339
Fax Number :
Provider Business Practice Location Address
First Line : 10065 E HARVARD AVE STE 400
Second Line :
City : DENVER
State : CO
Zip : 80231-5943
Country : US
Telephone Number : 303-614-1492
Fax Number : 303-614-1505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2007
Last Update Date : 11/05/2007

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