Individual
GRACE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
5715 KITTERY DR, COLORADO SPRINGS, CO 80911-3551
(719) 392-3883
(719) 390-6338
Mailing address
5715 KITTERY DR, COLORADO SPRINGS, CO 80911-3551
(719) 392-3883
(719) 390-6338
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
8948
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8948
COLORADO LICENSE
CO
Enumeration date
05/15/2023
Last updated
02/11/2025
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