Provider Demographics
NPI:1063257855
Name:ZAITZEW, DANIELLE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:ZAITZEW
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7418 MOUNT SHERMAN RD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-8678
Mailing Address - Country:US
Mailing Address - Phone:303-409-0132
Mailing Address - Fax:
Practice Address - Street 1:515 COFFMAN ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5455
Practice Address - Country:US
Practice Address - Phone:303-409-0132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0126838163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn