=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053859983
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIELLE MARIE SANDERS APN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2017
-----------------------------------------------------
Last Update Date | 04/20/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6169 S BALSAM WAY STE 220
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80123-3063
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-933-8526
-----------------------------------------------------
Fax | 303-933-8964
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10035 W DARTMOUTH AVE APT 207
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80227-5670
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-725-8666
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APN.0993416-NP
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------