Healthcare Provider Details

I. General information

NPI: 1891276051
Provider Name (Legal Business Name): DANIELLE ELYSE HUDSON CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS DANIELLE ELYSE BIRO

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 ELLIOTT DR 2ND FLOOR
YPSILANTI MI
48197
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DRIVE SUITE J2000
ANN ARBOR MI
48105
US

V. Phone/Fax

Practice location:
  • Phone: 800-436-1936
  • Fax:
Mailing address:
  • Phone: 734-747-6766
  • Fax: 734-222-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4704289946
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704289946
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: