Provider Demographics
NPI:1972601805
Name:DANIELS, RONNI H (FNP)
Entity Type:Individual
Prefix:MRS
First Name:RONNI
Middle Name:H
Last Name:DANIELS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:RONNI
Other - Middle Name:H
Other - Last Name:LEVINER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:147 BACK TEE CIR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485
Mailing Address - Country:US
Mailing Address - Phone:803-312-4213
Mailing Address - Fax:803-252-0611
Practice Address - Street 1:9900 BREN RD E
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9664
Practice Address - Country:US
Practice Address - Phone:843-560-9709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN1275363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF63863OtherPRESCRIPTIVE AUTHORITY