DR. DANIELLE PRUNTY RAEBURN (NPI# 1659384048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659384048 |
| Entity Type | Individual |
| Full Name | DR. DANIELLE PRUNTY RAEBURN |
| Credential | MD |
| Practice Address |
8300 W 38th Ave Wheat Ridge CO 80033-6005 |
| Mailing Address |
3156 Dayton St Denver CO 80238-2933 |
| Practice Telephone | 3034252087 |
| Mailing Telephone | 7209341552 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2014-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
39977 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RR MEDICARE | P00281206 | 01 | |
| CO | 24037389 | 05 |
| Street Address |
8300 W 38TH AVE |
| City | WHEAT RIDGE |
| State | CO |
| Zip Code | 80033-6005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669461281 | Scl Health Front Range, Inc | Internal Medicine | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2005-10-17 |
| 1811503766 | Noah Edward Dommer | Nurse Practitioner | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2020-09-16 |
| 1629689476 | Healthone Clinic Services-surgical Specialties LLC | Surgery | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2020-08-14 |
| 1699385922 | Kelly Sotir | Nurse Practitioner | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2020-08-02 |
| 1770193112 | Mikkala Shae Vosmera | Nurse Practitioner | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2020-07-31 |
| 1609485523 | Kari Envik | Nurse Practitioner | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2020-07-27 |
| 1528682903 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2020-06-02 |
| 1093335051 | Rebecca A Green | Nurse Practitioner | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2020-04-20 |
| 1922637321 | Jillian Rouse | Registered Nurse | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2020-04-07 |
| 1073159166 | Ellen Margaret Rohan | Nurse Practitioner | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2019-11-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154893915 | Bronwyn Hockersmith | Counselor | 3954 Yosemite St, Wheat Ridge, CO 80033 | 2018-12-18 |
| 1902392004 | Thousand Peaks Healthcare, Inc. | In Home Supportive Care | 4891 Independence St Ste 285, Wheat Ridge, CO 80033 | 2018-07-02 |
| 1528586120 | Front Range Family Resource Center | Marriage & Family Therapist | 5181 Ward St Ste 201, Wheat Ridge, CO 80033 | 2017-09-03 |
| 1962920918 | Dianna Lee Cordero | Counselor | 4931 Garrison St., Apt 104, Wheat Ridge, CO 80033 | 2017-08-30 |
| 1396261525 | Lauren Faye Petasne | Nurse Practitioner | 7100 W 44th Ave Ste 101a, Wheat Ridge, CO 80033 | 2017-08-18 |
| 1558802421 | Elizabeth Ann Huddleston | Nurse Practitioner | 3400 N Lutheran Pkwy, Wheat Ridge, CO 80033 | 2017-03-13 |
| 1053777045 | Richard Kerry Brandow | Counselor | 16625 W 50th Ave., Golden, CO 80033 | 2016-01-07 |
| 1831562131 | Eternal Life Care Centers, LLC | Assisted Living Facility | 4370 Ingalls Street, Wheat Ridge, CO 80033 | 2015-11-09 |
| 1740663483 | Real Care, Inc. | Private Vehicle | 10200 West 44th Ave, Suite 200, Wheat Ridge, CO 80033 | 2015-06-30 |
| 1508254848 | Pamela June Weitzel | Midwife | 3555 Lutheran Parkway Suite 210, Wheat Ridge, CO 80033 | 2015-01-08 |
| Find all providers in zip 80033 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619903564 | Julie Seaman | Emergency Medicine | Lutheran Medical Center Emergency Dept, 8300 West 38th Ave, Wheat Ridge, CO 80033 | 2006-06-23 |
| 1245289966 | Michael John Stackpool | Emergency Medicine | 8300 W. 38 Ave., Wheat Ridge, CO 80033 | 2006-05-09 |
| 1669714994 | Walter Grenell Jr. | Emergency Medicine | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2013-03-25 |
| 1447449947 | Daniel W Cheek | Emergency Medicine | 8300 W 38th Ave, Lutheran Medical Center, Wheat Ridge, CO 80033-6005 | 2007-10-20 |
| 1346452414 | Michael S Wisniewski | Emergency Medicine | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2007-05-03 |
| 1548272354 | Elin Kathleen Bartell | Emergency Medicine | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2006-08-12 |
| 1811907298 | Joanne Marie Edney | Emergency Medicine | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2006-08-09 |
| 1184634925 | Jeffrey Scott Beckman | Emergency Medicine | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2006-08-08 |
| 1558370726 | Kelli Don Jones | Emergency Medicine | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2006-08-05 |
| 1760491369 | Homi Kapadia | Emergency Medicine | 8300 W 38th Ave, Wheat Ridge, CO 80033-6005 | 2006-08-05 |
| Find all providers in WHEAT RIDGE | ||||
| City | WHEAT RIDGE |
| Zip Code | 80033 |
Please comment or provide details below to improve the information on DR. DANIELLE PRUNTY RAEBURN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.