Provider Demographics
NPI:1972950020
Name:SPEARS, SYREETA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SYREETA
Middle Name:
Last Name:SPEARS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13123 E 16TH AVE
Mailing Address - Street 2:GARY PAVILION 4TH FLOOR
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7106
Mailing Address - Country:US
Mailing Address - Phone:720-777-3502
Mailing Address - Fax:720-777-7311
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:GARY PAVILION 4TH FLOOR
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-3502
Practice Address - Fax:720-777-7311
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0181932163W00000X
COAPN.0993017-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse