Healthcare Provider Details

I. General information

NPI: 1457261802
Provider Name (Legal Business Name): NADIA DANIELA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 BROADWAY ST
EAGLE CO
81631-0660
US

IV. Provider business mailing address

PO BOX 660 551 BROADWAY ST
EAGLE CO
81631-0660
US

V. Phone/Fax

Practice location:
  • Phone: 970-328-8840
  • Fax: 855-848-8829
Mailing address:
  • Phone: 970-328-8840
  • Fax: 855-848-8829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1705656
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: