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NPI Code Detail

MEDICARE: DANIELLE N DAVIDSON NP

MEDICARE: DANIELLE N DAVIDSON NP
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
1363L00000XNurse Practitioner71002105IN

General Provider Information

NPI Number : 1366477820
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE N DAVIDSON NP
Provider Business Mailing Address
First Line : 8450 NORTHWEST BLVD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46278-1381
Country : US
Telephone Number : 317-802-2000
Fax Number : 317-802-2170
Provider Business Practice Location Address
First Line : 8402 HARCOURT RD STE 125
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-2094
Country : US
Telephone Number : 317-802-2000
Fax Number : 317-802-3972
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 05/08/2024

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