MEDICARE: DANIELLE MASON RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator	RN324145	GA

General Provider Information

NPI Number	:	1336981190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MASON RN

Provider Business Mailing Address
First Line	:	2578 MILL CREEK RD
Second Line	:
City	:	HIAWASSEE
State	:	GA
Zip	:	30546-5117
Country	:	US
Telephone Number	:	386-503-9460
Fax Number	:

Provider Business Practice Location Address
First Line	:	2578 MILL CREEK RD
Second Line	:
City	:	HIAWASSEE
State	:	GA
Zip	:	30546-5117
Country	:	US
Telephone Number	:	386-503-9460
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2024
Last Update Date	:	06/11/2024

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