Provider Demographics
NPI:1376282418
Name:KASSMEIER, DANIELLE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:KASSMEIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9235 CROWN CREST BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8881
Mailing Address - Country:US
Mailing Address - Phone:720-458-6543
Mailing Address - Fax:720-458-6544
Practice Address - Street 1:9235 CROWN CREST BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8881
Practice Address - Country:US
Practice Address - Phone:720-458-6543
Practice Address - Fax:720-458-6544
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2355538363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner