| Doctor Name: | DAN LOUIS KOLILIS |
| NPI Number: | 1194174730 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | N-35484 |
| Business Practice Address: | 47754 Foothill Rd Haines, OR - 978336403 |
| Business Phone Number: | 5414034863 |
| Business Fax Number: | |
| Mailing Address: | 47754 Foothill Rd, HAINES |
| State: | OR |
| Postal Code: | 978336403 |
| Phone Number: | 5414034863 |
| Fax Number: | |
| NPI Enumeration Date: | 06/04/2016 |
| NPI Last Update Date: | 06/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | N-35484 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |