Healthcare Provider Details

I. General information

NPI: 1568327641
Provider Name (Legal Business Name): ELIZABETH W DANIEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3915 DENFELD AVE
KENSINGTON MD
20895-1510
US

IV. Provider business mailing address

9689 BASKET RING RD APT 4
COLUMBIA MD
21045-3432
US

V. Phone/Fax

Practice location:
  • Phone: 301-396-0943
  • Fax:
Mailing address:
  • Phone: 301-395-0943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR178468
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: