Provider Demographics
NPI:1851636732
Name:DANIEL, MATTHEW ALAN (APRN)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ALAN
Last Name:DANIEL
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10995 QUIVIRA RD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1207
Mailing Address - Country:US
Mailing Address - Phone:913-339-9437
Mailing Address - Fax:913-339-9538
Practice Address - Street 1:4061 INDIAN CREEK PKWY
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66207-4030
Practice Address - Country:US
Practice Address - Phone:913-317-7990
Practice Address - Fax:913-317-7018
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5089111N00000X
KS53-79858-071363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care