Provider Demographics
NPI:1154583821
Name:LEINS, DARLENA DARLA MICHELLE
Entity type:Individual
Prefix:
First Name:DARLENA DARLA
Middle Name:MICHELLE
Last Name:LEINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DARLENA DARLA
Other - Middle Name:MICHELLE
Other - Last Name:LEINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 912215
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-2215
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:1024 S LEMAY AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3929
Practice Address - Country:US
Practice Address - Phone:970-495-7000
Practice Address - Fax:303-306-7753
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO2362207P00000X
CODR.0053850207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP01386957OtherRAILROAD MEDICARE
CO93222262Medicaid
CO93222262Medicaid