MEDICARE: MS. DANIELLE SPRY RN

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	390200000X	Student in an Organized Health Care Education/Training Program	28191190A	IN

General Provider Information

NPI Number	:	1457768905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANIELLE SPRY RN

Provider Business Mailing Address
First Line	:	7290 MARTOCK DR
Second Line	:
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-0046
Country	:	US
Telephone Number	:	317-459-0678
Fax Number	:

Provider Business Practice Location Address
First Line	:	7290 MARTOCK DR
Second Line	:
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-0046
Country	:	US
Telephone Number	:	317-459-0678
Fax Number	:

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

Provider Enumeration Date	:	07/16/2014
Last Update Date	:	06/04/2026

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