Provider Demographics
NPI:1396289161
Name:TIMMON, DANIELLE (RN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:TIMMON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 MONUMENT RD
Mailing Address - Street 2:#18B2
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225
Mailing Address - Country:US
Mailing Address - Phone:904-434-9633
Mailing Address - Fax:
Practice Address - Street 1:355 MONUMENT RD
Practice Address - Street 2:#18B2
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-6486
Practice Address - Country:US
Practice Address - Phone:904-434-9633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9392069163W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health