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NPI Code Detail

MEDICARE: DANIELLE NICOLE SAMUELSON LM, CPM

MEDICARE: DANIELLE NICOLE SAMUELSON LM, CPM
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
1176B00000XMidwife99492TX

General Provider Information

NPI Number : 1437878923
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE NICOLE SAMUELSON LM, CPM
Provider Business Mailing Address
First Line : 3505 SUMMER TRAIL CT
Second Line :
City : ARLINGTON
State : TX
Zip : 76016-3128
Country : US
Telephone Number : 817-584-7533
Fax Number :
Provider Business Practice Location Address
First Line : 3100 SWISS AVE
Second Line :
City : DALLAS
State : TX
Zip : 75204-6025
Country : US
Telephone Number : 469-291-9129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2022
Last Update Date : 08/26/2022

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