Provider Demographics
NPI:1205365913
Name:MENEFEE, DANIEL (NP-C)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:MENEFEE
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 TECH CENTER DR STE 250
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1987
Mailing Address - Country:US
Mailing Address - Phone:614-944-4800
Mailing Address - Fax:614-944-4750
Practice Address - Street 1:350 W WILSON BRIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2590
Practice Address - Country:US
Practice Address - Phone:614-796-2900
Practice Address - Fax:614-796-2901
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-06
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020773363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty