Provider Demographics
NPI:1275253460
Name:DANIELS, NICHOLAS (APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:DANIELS
Suffix:
Gender:M
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 ELDORADO PKWY BOX 150-153
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-8695
Mailing Address - Country:US
Mailing Address - Phone:469-598-1200
Mailing Address - Fax:
Practice Address - Street 1:15340 DALLAS PKWY STE 2400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-6459
Practice Address - Country:US
Practice Address - Phone:972-865-3506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049556363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner