Provider Demographics
NPI:1033622493
Name:FERNALD, DANIELLE (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:FERNALD
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:BRAGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 COMMERCE ST STE 700
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1835
Mailing Address - Country:US
Mailing Address - Phone:615-627-2293
Mailing Address - Fax:
Practice Address - Street 1:2425 WEST LOOP S STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-4208
Practice Address - Country:US
Practice Address - Phone:832-786-4970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134652363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily