Provider Demographics
NPI:1598257297
Name:DANIELSON, KATHERINE ROSE (CNM)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ROSE
Last Name:DANIELSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4075 E 128TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2201
Mailing Address - Country:US
Mailing Address - Phone:303-925-4240
Mailing Address - Fax:303-925-4242
Practice Address - Street 1:4075 E 128TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2201
Practice Address - Country:US
Practice Address - Phone:303-925-4240
Practice Address - Fax:303-925-4242
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
367A00000X
COAPN.0993925-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife