Provider Demographics
NPI:1144661455
Name:DOEDENS, DANIELLE LANE (MSN, FNP)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:LANE
Last Name:DOEDENS
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 ELM ST
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2467
Mailing Address - Country:US
Mailing Address - Phone:770-887-1668
Mailing Address - Fax:770-887-3462
Practice Address - Street 1:260 ELM ST
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2467
Practice Address - Country:US
Practice Address - Phone:770-887-1668
Practice Address - Fax:770-887-3462
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN203965363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily