Healthcare Provider Details

I. General information

NPI: 1548903842
Provider Name (Legal Business Name): DANIELLE MARIE BURSELL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 UNIVERSITY AVE STE 450
WEST DES MOINES IA
50266-8229
US

IV. Provider business mailing address

PO BOX 9170
DES MOINES IA
50306-9170
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-2010
  • Fax: 515-241-2009
Mailing address:
  • Phone: 515-633-3600
  • Fax: 515-633-3838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number116590
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: