Healthcare Provider Details

I. General information

NPI: 1053926527
Provider Name (Legal Business Name): BRIAN MICHAEL DAFT AGACNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 S BROADWAY
LITTLETON CO
80122-2602
US

IV. Provider business mailing address

7700 S BROADWAY
LITTLETON CO
80122-2602
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-8900
  • Fax: 303-738-7755
Mailing address:
  • Phone: 303-730-8900
  • Fax: 303-738-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberC-APN.0106323-C-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number247853
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: