Provider Demographics
NPI:1962200246
Name:THORNE, MARISSA DANIELLE (RN)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:DANIELLE
Last Name:THORNE
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 CRABAPPLE ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7973
Mailing Address - Country:US
Mailing Address - Phone:870-833-0180
Mailing Address - Fax:
Practice Address - Street 1:340 EXEMPLA CIR FL 2
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3384
Practice Address - Country:US
Practice Address - Phone:870-833-0180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1664137163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology