Provider Demographics
NPI:1134463896
Name:MINTON, DANIELLE W (ANP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:W
Last Name:MINTON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:RENEE
Other - Last Name:WITTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 29TH AVE N STE 202
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1448
Mailing Address - Country:US
Mailing Address - Phone:615-327-4304
Mailing Address - Fax:615-327-7940
Practice Address - Street 1:110 29TH AVE N STE 202
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1448
Practice Address - Country:US
Practice Address - Phone:615-327-4304
Practice Address - Fax:615-327-7940
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17122363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health