Provider Demographics
NPI:1346835238
Name:DESMARAIS, LISA DANIELLE (CNM)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:DANIELLE
Last Name:DESMARAIS
Suffix:
Gender:
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 S ANDES CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4574
Mailing Address - Country:US
Mailing Address - Phone:248-730-4444
Mailing Address - Fax:
Practice Address - Street 1:8111 E LOWRY BLVD STE 230
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7255
Practice Address - Country:US
Practice Address - Phone:720-464-7599
Practice Address - Fax:720-306-5392
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0996291367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife