| Doctor Name: | MR. DANIEL MARK BURNELL |
| NPI Number: | 1316045362 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | B.S., M.A., PA-C |
| License Number: | PA2002-0003NM |
| Business Practice Address: | 255 Sw 8th Ave Cedaredge, CO - 814133902 |
| Business Phone Number: | 9708563146 |
| Business Fax Number: | 9708564385 |
| Mailing Address: | 255 Sw 8th Ave, CEDAREDGE |
| State: | CO |
| Postal Code: | 814133902 |
| Phone Number: | 9708563146 |
| Fax Number: | 9708564385 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 11/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA2002-0003NM |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |