1386650216 NPI number — DR. DANIEL E. KNUDSEN AU.D.

Table of content: DR. DANIEL E. KNUDSEN AU.D. (NPI 1386650216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386650216 NPI number — DR. DANIEL E. KNUDSEN AU.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNUDSEN
Provider First Name:
DANIEL
Provider Middle Name:
E.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AU.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KNUDSEN
Provider Other First Name:
DANIEL
Provider Other Middle Name:
E.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
AU.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1386650216
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 208
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WELLINGTON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80549-0208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-817-2300
Provider Business Mailing Address Fax Number:
970-817-2301

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3725 CLEVELAND AVE., UNIT I
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WELLINGTON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80549-0208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-817-2300
Provider Business Practice Location Address Fax Number:
970-817-2301
Provider Enumeration Date:
07/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  643 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 643 . This is a "COLORADO AUDIOLOGY LICENSE NUMBER" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 42 . This is a "ALASKA AUDIOLOGY LICENSE NUMBER" identifier , issued by the state of ( AK ) . This identifiers is of the category "OTHER".
  • Identifier: 23002456A . This is a "INDIANA AUDIOLOGY LICENSE NUMBER" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com