Provider Demographics
NPI:1508979394
Name:DANIELSON, ANGELA (RN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:DANIELSON
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 1:8629 RHINELAND DR
Mailing Address - Street 2:
Mailing Address - City:FORT IRWIN
Mailing Address - State:CA
Mailing Address - Zip Code:92310-2426
Mailing Address - Country:US
Mailing Address - Phone:760-386-2905
Mailing Address - Fax:
Practice Address - Street 1:166 3RD ST.
Practice Address - Street 2:WEED ARMY COMMUNITY HOSPITAL BLDG
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310
Practice Address - Country:US
Practice Address - Phone:760-380-3114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX713876163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency