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NPI Code Detail

MEDICARE: DANIELLE MARIE COULSON DNP

MEDICARE: DANIELLE MARIE COULSON DNP
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 Practitioner4704286825MI

General Provider Information

NPI Number : 1790298503
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE MARIE COULSON DNP
Provider Business Mailing Address
First Line : 130 TOWN CENTER DR STE 203
Second Line :
City : TROY
State : MI
Zip : 48084-1744
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3601 W 13 MILE RD
Second Line :
City : ROYAL OAK
State : MI
Zip : 48073-6712
Country : US
Telephone Number : 248-898-2800
Fax Number : 248-898-2898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2017
Last Update Date : 11/15/2017

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