Basic Information
| Provider Information | |||||||||
| NPI: | 1962544189 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DANIELSON | ||||||||
| FirstName: | NANCY | ||||||||
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| Credential: | APRN, CNS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 981 HOWELL ST | ||||||||
| Address2: | |||||||||
| City: | SHEFFIELD LAKE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440542021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409492633 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6140 S BROADWAY | ||||||||
| Address2: | |||||||||
| City: | LORAIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440533821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402044364 | ||||||||
| FaxNumber: | 4402339070 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2007 | ||||||||
| LastUpdateDate: | 09/06/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | RN-187505 | OH | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 363LC1500X | COA02901NS | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Community Health |
No ID Information.