1679664593 NPI number — MRS. NANCY M. DANIELS I APRN,BC

Table of content: MRS. NANCY M. DANIELS I APRN,BC (NPI 1679664593)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679664593 NPI number — MRS. NANCY M. DANIELS I APRN,BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANIELS
Provider First Name:
NANCY
Provider Middle Name:
M.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
I
Provider Credential Text:
APRN,BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679664593
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9480 HUEBNER ROAD
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78240-1657
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-614-9595
Provider Business Mailing Address Fax Number:
210-615-7362

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9480 HUEBNER ROAD
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78240-1657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-614-9595
Provider Business Practice Location Address Fax Number:
210-615-7362
Provider Enumeration Date:
09/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  599254 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 364SP0808X , with the licence number: 599254 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 89N353 43HQ . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: F0129796 . This is a "DPS NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0366202-34 . This is a "ANCC PSYCH NP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0097871-01 . This is a "ANCC CERTIFICATION SPEC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 039575802 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 599254 . This is a "NURSING-ADVANCED PRACTICE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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