MEDICARE: EMILY J DANIELSON FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	249021	AZ

General Provider Information

NPI Number	:	1114875614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY J DANIELSON FNP-BC

Provider Business Mailing Address
First Line	:	2055 E SOUTHERN AVE STE A
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2055 E SOUTHERN AVE STE A
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7507
Country	:	US
Telephone Number	:	602-282-0080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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