Provider Demographics
NPI:1720097512
Name:RAMIREZ, DANIEL (NP-C)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 BLUE HERON DR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-1995
Mailing Address - Country:US
Mailing Address - Phone:303-946-8843
Mailing Address - Fax:720-439-7762
Practice Address - Street 1:23 BLUE HERON DR
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-1995
Practice Address - Country:US
Practice Address - Phone:303-946-8843
Practice Address - Fax:720-439-7762
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103080363L00000X
CO0004452363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53780850Medicaid
CO808378OtherMEDICARE TYPE ID
CO808378Medicare PIN
CO808378OtherMEDICARE TYPE ID
802508Medicare ID - Type Unspecified
CO53780850Medicaid