Basic Information
| Provider Information | |||||||||
| NPI: | 1659889400 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DANIELS | ||||||||
| FirstName: | ERIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 750 W HAMPDEN AVE STE 105 | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801102167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033414730 | ||||||||
| FaxNumber: | 3033414708 | ||||||||
| Practice Location | |||||||||
| Address1: | 6080 W 92ND AVE STE 1000 | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800312935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034270796 | ||||||||
| FaxNumber: | 3034299399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2018 | ||||||||
| LastUpdateDate: | 08/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APN.0993496-NP | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 9000156869 | 05 | CO | MEDICAID |