Provider Demographics
NPI:1083380414
Name:DANIEL, ZEENA (CRNP)
Entity Type:Individual
Prefix:
First Name:ZEENA
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7116 MAIDEN POINT PL
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6509
Mailing Address - Country:US
Mailing Address - Phone:808-222-1673
Mailing Address - Fax:
Practice Address - Street 1:10816 HICKORY RIDGE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3622
Practice Address - Country:US
Practice Address - Phone:808-222-1673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR205005363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily