DR. TRACY DANIELLE MAHVAN (NPI# 1689047268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689047268 |
| Entity Type | Individual |
| Full Name | DR. TRACY DANIELLE MAHVAN |
| Credential | PHARMD |
| Practice Address |
7157 Waterford Ct 7157 Waterford Ct Niwot CO 80503-7649 |
| Practice Telephone | 3033594569 |
| Mailing Telephone | 3033594569 |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
14458 | CO | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
14458 | CO | Pharmacy Service Providers |
| N | 1835G0303X |
Pharmacist Specialization: Geriatric |
14458 | CO | Pharmacy Service Providers |
| N | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
14458 | CO | Pharmacy Service Providers |
| Street Address |
7157 WATERFORD CT 7157 WATERFORD CT |
| City | NIWOT |
| State | CO |
| Zip Code | 80503-7649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073145025 | Home Care Colorado, LLC | In Home Supportive Care | 2919 17th Ave., Suite 215, Longmont, CO 80503 | 2020-02-07 |
| 1639644016 | Katherine and Charles Hover Greenhouses Inc | Skilled Nursing Facility | 1425 Belmont Dr, Longmont, CO 80503 | 2018-10-11 |
| 1467981993 | Donna Faye Georje Mchaney | Nurse Practitioner | 903 Reynolds Farm Lane, Longmont, CO 80503 | 2017-06-08 |
| 1972030161 | Advanced Vision Surgery Center LLC | Clinic/Center | 1390 Dry Creek Drive, Longmont, CO 80503 | 2017-05-18 |
| 1063958338 | Longmont Tc, LLC | Skilled Nursing Facility | 1960 South Fordham St, Longmont, CO 80503 | 2017-01-11 |
| 1710340211 | Rachel A Schreiber | Optometrist | 8900 Prairie Knoll Dr, Longmont, CO 80503 | 2016-04-01 |
| 1427368299 | Sally Anne Thompson | Specialist | 3664 Oakwood Drive, Longmont, CO 80503 | 2010-10-14 |
| 1124357082 | Penny Trevithick | Specialist | 8380 Hygiene Rd, Longmont, CO 80503 | 2009-12-23 |
| 1104155381 | Adrienne R. Leeds | Midwife | 1736 Clover Creek Dr, Longmont, CO 80503 | 2009-12-16 |
| 1003142928 | Sarah Jean Dubbe | Massage Therapist | 1690 Brown Court, Longmont, CO 80503 | 2009-10-28 |
| Find all providers in zip 80503 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285261479 | Jennifer Elizabeth Jackson | Pharmacist | 4675 W 37th Ave Apt 202, Denver, CO 80212-2079 | 2020-03-26 |
| 1427544139 | Douglas Norman Fish | Pharmacist | 6552 Starlight Dr, Morrison, CO 80465-2711 | 2018-07-05 |
| 1508366576 | Converge Health, LLC | Pharmacist | 4410 Orofino Pl, Castle Rock, CO 80108 | 2018-02-16 |
| 1417488776 | Cynthia Love Pursell | Pharmacist | 910 Rush Drive, Salida, CO 81201 | 2017-03-27 |
| 1790237238 | Melissa Linda Hubbard | Pharmacist | 12484 Black Hills Dr, Peyton, CO 80831-4420 | 2016-11-01 |
| 1184015851 | Liban Warsame | Pharmacist | 2797 Wewatta Way Unit 2049, Denver, CO 80216-3644 | 2015-02-16 |
| 1962800128 | Michael Woodley | Pharmacist | 1110 Edenhurst Ct, Monument, CO 80132-8484 | 2014-12-19 |
| 1588062277 | Lesley Brooke Liebig | Pharmacist | 1625 E Stuart St Apt E47, Fort Collins, CO 80525-1339 | 2014-12-11 |
| 1609283837 | Lucas Smith | Pharmacist | 403 Us Highway 24 South, Buena Vista, CO 81211 | 2014-07-21 |
| 1457788366 | Marianna Yanashyan | Pharmacist | 2500 S Havana Ave, Aurora, CO 80014 | 2013-10-09 |
| Find all providers with the same taxonomy | ||||
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| 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.