Provider Demographics
NPI:1790522696
Name:SMITH, CECILIA MARIE (MSN)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9444 W HINSDALE PL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4168
Mailing Address - Country:US
Mailing Address - Phone:720-231-7244
Mailing Address - Fax:
Practice Address - Street 1:4155 E JEWELL AVE STE 500
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4509
Practice Address - Country:US
Practice Address - Phone:720-310-2773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0999930363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health