Healthcare Provider Details

I. General information

NPI: 1780214551
Provider Name (Legal Business Name): DANNI LANE ELDRED NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 S DOWNING ST
DENVER CO
80210-5855
US

IV. Provider business mailing address

2220 CANTERBURY DR
HAYS KS
67601-2370
US

V. Phone/Fax

Practice location:
  • Phone: 303-715-7030
  • Fax: 303-715-7035
Mailing address:
  • Phone: 785-623-5774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0997440-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-79067-071
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: