1912188699 NPI number — MRS. DANA ANN MORRIS-BLAKE NP

Table of content: MRS. DANA ANN MORRIS-BLAKE NP (NPI 1912188699)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912188699 NPI number — MRS. DANA ANN MORRIS-BLAKE NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRIS-BLAKE
Provider First Name:
DANA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORRIS
Provider Other First Name:
DANA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MAIDEN - 10/16/98
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912188699
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 202926
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80220-8926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-277-9860
Provider Business Mailing Address Fax Number:
888-341-0822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
91 NEWARK ST
Provider Second Line Business Practice Location Address:
UNIT D
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80012-1629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-525-7997
Provider Business Practice Location Address Fax Number:
888-384-7012
Provider Enumeration Date:
11/21/2007

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: 101Y00000X , with the licence number:  NLC.0111278 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: NP4933 , 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: 56481870 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1037 . This is a "RXN" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 4933 . This is a "NP FAMILY HEALTH AUTHORITY NUMBER" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: NLC.0111278 . This is a "COLORADO BOARD OF PSYCHOTHERAPISTS" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 2019084966 . This is a "AMER NURSES CREDENTIALING CENTER - FAMILY NURSE PRACTITIONER BOARD CERTIFICATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 175733 . This is a "COLORADO RN LICENSE NUMBER" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: RXP-1037 . This is a "COLORADO PRESCRIPTIVE AUTHORITY NUMBER" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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