Provider Demographics
NPI:1811561160
Name:DANIELS, ADRIENNE LASHAWN (NP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:LASHAWN
Last Name:DANIELS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 SIERRA TRL
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-4929
Mailing Address - Country:US
Mailing Address - Phone:214-783-4146
Mailing Address - Fax:
Practice Address - Street 1:9202 ELAM RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-4151
Practice Address - Country:US
Practice Address - Phone:214-266-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2022-02-16
Deactivation Date:2021-07-12
Deactivation Code:
Reactivation Date:2022-02-16
Provider Licenses
StateLicense IDTaxonomies
TX1035470363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health