Provider Demographics
NPI:1871038182
Name:MCGUIRE, DANIELLE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MCGUIRE
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 1:10135 W KENTUCKY DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3942
Mailing Address - Country:US
Mailing Address - Phone:720-469-8475
Mailing Address - Fax:303-985-4321
Practice Address - Street 1:10135 W KENTUCKY DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3942
Practice Address - Country:US
Practice Address - Phone:720-469-8475
Practice Address - Fax:303-985-4321
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CO225700000X261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service