Healthcare Provider Details

I. General information

NPI: 1356275911
Provider Name (Legal Business Name): DARYA KOVALCHUK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4567 E 9TH AVE
DENVER CO
80220-3908
US

IV. Provider business mailing address

3550 W 38TH AVE APT 364
DENVER CO
80211-1860
US

V. Phone/Fax

Practice location:
  • Phone: 303-320-2121
  • Fax:
Mailing address:
  • Phone: 650-477-5692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1702103
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: