Provider Demographics
NPI:1437359072
Name:MASSEY, DANIEL FRANK (FNP)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:FRANK
Last Name:MASSEY
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 W 187TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5826
Mailing Address - Country:US
Mailing Address - Phone:310-245-4400
Mailing Address - Fax:
Practice Address - Street 1:920 SECOND AVE SOUTH, SUITE 400
Practice Address - Street 2:MINUTE CLINIC
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402
Practice Address - Country:US
Practice Address - Phone:612-225-1512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA389692363LF0000X
CA17050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABE989ZMedicare PIN