Healthcare Provider Details

I. General information

NPI: 1285539189
Provider Name (Legal Business Name): DANIELLE EMERSON PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2026
Last Update Date: 10/12/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 W HARTFORD AVE
PHOENIX AZ
85023-2692
US

IV. Provider business mailing address

706 W HARTFORD AVE
PHOENIX AZ
85023-2692
US

V. Phone/Fax

Practice location:
  • Phone: 602-783-2938
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number222049
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: