Individual
TRAE SMART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
5360 N ACADEMY BLVD, COLORADO SPRINGS, CO 80918-4006
(719) 434-2061
Mailing address
7577 COPPER CREST VW # E404, COLORADO SPRINGS, CO 80908-4836
(813) 894-1298
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5260904
FL
Other
Enumeration date
09/22/2025
Last updated
09/22/2025
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