Provider Demographics
NPI:1275746372
Name:DANIELS, FELICIA MARIE (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:MARIE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MRS
Other - First Name:FELICIA
Other - Middle Name:MARIE
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:510 29 .5 RD.
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-5033
Mailing Address - Country:US
Mailing Address - Phone:970-248-6932
Mailing Address - Fax:970-254-4118
Practice Address - Street 1:510 29 .5 RD.
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81502-5033
Practice Address - Country:US
Practice Address - Phone:970-248-6932
Practice Address - Fax:970-254-4118
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO166320163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse