MEDICARE: MICHELLE JOY DANIELS 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	363LF0000X	Family Nurse Practitioner	9323726	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851819809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE JOY DANIELS RN

Provider Business Mailing Address
First Line	:	3027 MAIN ST
Second Line	:
City	:	VERNON
State	:	FL
Zip	:	32462-2220
Country	:	US
Telephone Number	:	850-535-0703
Fax Number	:

Provider Business Practice Location Address
First Line	:	3027 MAIN ST
Second Line	:
City	:	VERNON
State	:	FL
Zip	:	32462-2220
Country	:	US
Telephone Number	:	850-535-0703
Fax Number	:

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

Provider Enumeration Date	:	08/30/2017
Last Update Date	:	07/21/2022

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