Healthcare Provider Details

I. General information

NPI: 1003683723
Provider Name (Legal Business Name): DANIELLE MARIN HENDRICKSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 E RIGGS RD STE 7
CHANDLER AZ
85249-3683
US

IV. Provider business mailing address

261 N ROOSEVELT AVE
CHANDLER AZ
85226-2617
US

V. Phone/Fax

Practice location:
  • Phone: 480-677-8282
  • Fax: 888-316-1686
Mailing address:
  • Phone: 480-677-8282
  • Fax: 888-316-1686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number227957
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number227957
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: