Healthcare Provider Details

I. General information

NPI: 1356278832
Provider Name (Legal Business Name): NIKITA DANIELY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NIKITA DANIELY RN

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1474
ASPEN CO
81612-1474
US

IV. Provider business mailing address

PO BOX 1474
ASPEN CO
81612-1474
US

V. Phone/Fax

Practice location:
  • Phone: 970-404-1330
  • Fax:
Mailing address:
  • Phone: 970-404-1330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1650197
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number1650197
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number1650197
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code374K00000X
TaxonomyReligious Nonmedical Practitioner
License Number1650197
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number1650197
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: