Healthcare Provider Details

I. General information

NPI: 1487591939
Provider Name (Legal Business Name): DANIKA IVAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48338 POWDERHORN RD
MESA CO
81643-5099
US

IV. Provider business mailing address

1708 HALL AVE
GRAND JUNCTION CO
81501-6330
US

V. Phone/Fax

Practice location:
  • Phone: 970-268-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number0735-7534-4313
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: