Provider Demographics
NPI:1376012070
Name:DANIELS, TAMBRA RENEE (APNP, FN-BC)
Entity type:Individual
Prefix:MS
First Name:TAMBRA
Middle Name:RENEE
Last Name:DANIELS
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Gender:F
Credentials:APNP, FN-BC
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Mailing Address - Street 1:COMPASS BEHAVIORAL HEALTH CLINIC
Mailing Address - Street 2:1820 CENTER AVENUE
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546
Mailing Address - Country:US
Mailing Address - Phone:608-755-1475
Mailing Address - Fax:608-755-1733
Practice Address - Street 1:1820 CENTER AVE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-2802
Practice Address - Country:US
Practice Address - Phone:608-755-1475
Practice Address - Fax:608-755-1733
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2020-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI8930-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily