Individual
DANIELLE N. MIANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524-3929
(970) 495-7000
(303) 306-7753
Mailing address
PO BOX 912215, DENVER, CO 80291-2215
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A124963
CA
207P00000X
Emergency Medicine Physician
Primary
DR.0053787
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16433734
—
CO
01
—
P01378288
RAILROAD MEDICARE
CO
Enumeration date
03/24/2010
Last updated
06/29/2015
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