Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | SP015448 | PA |
NPI | 1063883890 |
---|---|
Provider Name | Danielle Jones |
First Address | Horsham, PA 19044-2223 |
Second Address | Horsham, PA 19044-2223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2015 |
Last Update Date | 04/12/2015 |