Provider Demographics
NPI:1629554134
Name:DANIEL TOUSSAINT, NADEGE
Entity Type:Individual
Prefix:
First Name:NADEGE
Middle Name:
Last Name:DANIEL TOUSSAINT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32351-2623
Mailing Address - Country:US
Mailing Address - Phone:850-662-4070
Mailing Address - Fax:850-662-4047
Practice Address - Street 1:809 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351-2623
Practice Address - Country:US
Practice Address - Phone:850-662-4070
Practice Address - Fax:850-662-4047
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9294754363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily