Provider Demographics
NPI:1144068388
Name:SMITH, KALEIGH NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:KALEIGH
Middle Name:NICOLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11684 HURON ST STE 104
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2942
Mailing Address - Country:US
Mailing Address - Phone:720-588-3249
Mailing Address - Fax:833-468-0039
Practice Address - Street 1:11684 HURON ST
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-2924
Practice Address - Country:US
Practice Address - Phone:720-588-3249
Practice Address - Fax:833-468-0039
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN0999974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily