Provider Demographics
NPI:1760684724
Name:GARCIA, DALE LYNETTE
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:LYNETTE
Last Name:GARCIA
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 1:12260 KEARNEY ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-4608
Mailing Address - Country:US
Mailing Address - Phone:303-457-3738
Mailing Address - Fax:
Practice Address - Street 1:12260 KEARNEY ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80602-4608
Practice Address - Country:US
Practice Address - Phone:303-457-3738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide