Provider Demographics
NPI:1437376134
Name:DANIELSON, LIANNA MARY (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:LIANNA
Middle Name:MARY
Last Name:DANIELSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 LAKE LOOP DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-8705
Mailing Address - Country:US
Mailing Address - Phone:406-257-5881
Mailing Address - Fax:406-257-5881
Practice Address - Street 1:191 JEWELL BASIN CT
Practice Address - Street 2:SUITE 2A
Practice Address - City:BIGFORK
Practice Address - State:MT
Practice Address - Zip Code:59911-6290
Practice Address - Country:US
Practice Address - Phone:406-837-4357
Practice Address - Fax:406-837-3957
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT29924363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily