1275746372 NPI number — MRS. FELICIA MARIE DANIELS RN, BSN

Table of content: MRS. FELICIA MARIE DANIELS RN, BSN (NPI 1275746372)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275746372 NPI number — MRS. FELICIA MARIE DANIELS RN, BSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANIELS
Provider First Name:
FELICIA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, BSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DANIELS
Provider Other First Name:
FELICIA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, BSN
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1275746372
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 29 .5 RD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND JUNCTION
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81502-5033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-248-6932
Provider Business Mailing Address Fax Number:
970-254-4118

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 29 .5 RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND JUNCTION
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81502-5033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-248-6932
Provider Business Practice Location Address Fax Number:
970-254-4118
Provider Enumeration Date:
05/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  166320 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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