Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 126286 | CO |
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN 829462, NP 22407 | CA |
NPI | 1003969734 |
---|---|
Provider Name | Danielle Marie Santry |
First Address | Golden, CO 80403-7445 |
Second Address | Golden, CO 80403-7445 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 29/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
126286 | STATE MEDICAL LICENSE (01) | CO |
22407 | CA NP CERTIFICATE NUMBER (01) | CA |
829462 | CA RN LICENSE (01) | CA |
88125548 | (05) | CO |
P40999 | (02) | CO |