Healthcare Provider Details

I. General information

NPI: 1265686034
Provider Name (Legal Business Name): DANIELLE H CADY DNP, ACNP-BC, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 REDSTONE AVE W
CRESTVIEW FL
32536-6433
US

IV. Provider business mailing address

129 WALTON GULF VIEW DR
SEACREST FL
32461-7123
US

V. Phone/Fax

Practice location:
  • Phone: 850-689-1740
  • Fax: 850-682-6652
Mailing address:
  • Phone: 251-776-3626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9195747
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: