Healthcare Provider Details

I. General information

NPI: 1306721535
Provider Name (Legal Business Name): DANIELLE GEORGIA HOTUJAC RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15809 W 81ST ST
LENEXA KS
66219-1840
US

IV. Provider business mailing address

15809 W 81ST ST
LENEXA KS
66219-1840
US

V. Phone/Fax

Practice location:
  • Phone: 913-626-9404
  • Fax:
Mailing address:
  • Phone: 913-626-9404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number151956
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: