Provider Demographics
NPI:1134758857
Name:MARSTON, DANIELLE IVY (NP)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:IVY
Last Name:MARSTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:GAUTEREAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 UNION BLVD STE 311
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1831
Mailing Address - Country:US
Mailing Address - Phone:303-566-7170
Mailing Address - Fax:303-566-7172
Practice Address - Street 1:200 UNION BLVD STE 311
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1831
Practice Address - Country:US
Practice Address - Phone:303-566-7170
Practice Address - Fax:303-566-7172
Is Sole Proprietor?:No
Enumeration Date:2020-04-04
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1645088163W00000X
CO0995949363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse