Provider Demographics
NPI:1710002142
Name:NIEHAUS, CHRISTOPHER DANIEL (NURSING ASSISTANT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DANIEL
Last Name:NIEHAUS
Suffix:
Gender:M
Credentials:NURSING ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3243 SPEARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-7563
Mailing Address - Country:US
Mailing Address - Phone:303-791-2633
Mailing Address - Fax:
Practice Address - Street 1:3243 SPEARWOOD DR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-7563
Practice Address - Country:US
Practice Address - Phone:303-791-2633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7149293140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric