MEDICARE: DANIELLE DANA EBRON FNP-C

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	363LF0000X	Family Nurse Practitioner	AP144211	TX

General Provider Information

NPI Number	:	1871127357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE DANA EBRON FNP-C

Provider Business Mailing Address
First Line	:	912 HERMAN ST
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-4733
Country	:	US
Telephone Number	:	832-586-0005
Fax Number	:	832-586-0930

Provider Business Practice Location Address
First Line	:	912 HERMAN ST
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-4733
Country	:	US
Telephone Number	:	832-586-0005
Fax Number	:	832-586-0930

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

Provider Enumeration Date	:	02/24/2020
Last Update Date	:	09/09/2025

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