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NPI Code Detail

MEDICARE: ESTELLE MARIE DANIEL FNP-BC

MEDICARE: ESTELLE MARIE DANIEL FNP-BC
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
1363LF0000XFamily Nurse Practitioner71007624AIN

General Provider Information

NPI Number : 1861903114
Entity Type Code : Individual
Provider Name (Legal Business Name) : ESTELLE MARIE DANIEL FNP-BC
Provider Business Mailing Address
First Line : 2824 CLIFFWOOD LN
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-7135
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9805 GEIST CROSSING DR # 6998
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-4819
Country : US
Telephone Number : 317-577-1353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2017
Last Update Date : 08/25/2021

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