Provider Demographics
NPI:1518154707
Name:DANKOF, LAURA (NP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DANKOF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BLACK FAWN LN
Mailing Address - Street 2:
Mailing Address - City:WESTCLIFFE
Mailing Address - State:CO
Mailing Address - Zip Code:81252-9604
Mailing Address - Country:US
Mailing Address - Phone:719-966-7773
Mailing Address - Fax:855-803-3490
Practice Address - Street 1:206 BLACK FAWN LN
Practice Address - Street 2:
Practice Address - City:WESTCLIFFE
Practice Address - State:CO
Practice Address - Zip Code:81252-9604
Practice Address - Country:US
Practice Address - Phone:719-966-7773
Practice Address - Fax:855-803-3490
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994074-NP363L00000X
IAA090468363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA71341OtherWELLMARK BLUE SHIELD
IA70815OtherWELLMARK BLUE SHIELD
IAI21305Medicare PIN