Healthcare Provider Details

I. General information

NPI: 1407068877
Provider Name (Legal Business Name): BRELYNN SHEREE DANIELS RN, FNP- BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2007
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 IVANHILL RD
TOLEDO OH
43615-5239
US

IV. Provider business mailing address

243 IVANHILL RD
TOLEDO OH
43615-5239
US

V. Phone/Fax

Practice location:
  • Phone: 419-704-9126
  • Fax:
Mailing address:
  • Phone: 419-704-9126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0029607
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN390353
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN116768
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberRR743890
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: