Provider Demographics
NPI:1336991447
Name:VERMULM, DANAE (FNP-C)
Entity Type:Individual
Prefix:
First Name:DANAE
Middle Name:
Last Name:VERMULM
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 1:4383 SEPULVEDA BLVD APT 502
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3971
Mailing Address - Country:US
Mailing Address - Phone:360-708-6503
Mailing Address - Fax:
Practice Address - Street 1:4383 SEPULVEDA BLVD APT 502
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3971
Practice Address - Country:US
Practice Address - Phone:360-708-6503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029216363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily