Healthcare Provider Details
I. General information
NPI: 1295394005
Provider Name (Legal Business Name): DANIELLE MCMILLEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/06/2019
Last Update Date: 09/20/2025
Certification Date: 09/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1316 S MAIN ST
CLARION IA
50525-2019
US
IV. Provider business mailing address
1316 S MAIN ST
CLARION IA
50525-2019
US
V. Phone/Fax
- Phone: 844-474-4321
- Fax: 515-532-3119
- Phone: 844-474-4321
- Fax: 319-343-1161
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | DO55474 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | R-11624 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: