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General NPI Number Information
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NPI Number | 1699473975
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Entity Type | Individual
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Provider Name | DANIELLE RICHARDSON DANIEL PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/16/2023
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 2343 2ND AVE E
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City | ONEONTA
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State | AL
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Zip | 35121-2756
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Country | US
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Telephone | 205-625-3332
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Fax |
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Provider Business Mailing Address
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Address Line | 8304 CAHABA CROSSING CIR
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City | LEEDS
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State | AL
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Zip | 35094-7901
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Country | US
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Telephone | 205-283-9841
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2151
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License Number State | AL
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