Provider Demographics
NPI:1073959383
Name:NEEDHAM, DANIELLE (RN, FNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:
Last Name:NEEDHAM
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 HIGHWAY 287 N
Mailing Address - Street 2:STE 150
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7595
Mailing Address - Country:US
Mailing Address - Phone:254-592-6078
Mailing Address - Fax:
Practice Address - Street 1:4025 HUFFINES BLVD
Practice Address - Street 2:APT 2115
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-6541
Practice Address - Country:US
Practice Address - Phone:254-592-6078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX743008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily