Basic Information
Provider Information
NPI: 1104839794
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANTZ
FirstName: DANIEL
MiddleName: A.
NamePrefix: MR.
NameSuffix:  
Credential: PMHCNS-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1300 N 17TH AVE
Address2:  
City: GREELEY
State: CO
PostalCode: 806319584
CountryCode: US
TelephoneNumber: 9703472120
FaxNumber: 9703469800
Practice Location
Address1: 1300 N 17TH AVE
Address2:  
City: GREELEY
State: CO
PostalCode: 806319584
CountryCode: US
TelephoneNumber: 9703472120
FaxNumber: 9703469800
Other Information
ProviderEnumerationDate: 08/14/2006
LastUpdateDate: 08/08/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
364SP0809XAPN.0000150-CNSCOY Physician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsych/Mental Health, Adult

No ID Information.


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