Healthcare Provider Details

I. General information

NPI: 1013653096
Provider Name (Legal Business Name): DANIELLE SCHEEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E HANNA AVE
INDIANAPOLIS IN
46227-3697
US

IV. Provider business mailing address

17747 KILLINGTON WAY
SOUTH BEND IN
46614-9773
US

V. Phone/Fax

Practice location:
  • Phone: 317-788-3368
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: