Provider Demographics
NPI:1407068877
Name:DANIELS, BRELYNN SHEREE (RN, FNP- BC)
Entity Type:Individual
Prefix:
First Name:BRELYNN
Middle Name:SHEREE
Last Name:DANIELS
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 1:243 IVANHILL RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-5239
Mailing Address - Country:US
Mailing Address - Phone:419-704-9126
Mailing Address - Fax:
Practice Address - Street 1:243 IVANHILL RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-5239
Practice Address - Country:US
Practice Address - Phone:419-704-9126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN390353163W00000X
OHPN116768164W00000X
OHAPRN.CNP.0029607363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse