Provider Demographics
NPI:1538377908
Name:DANIEL, HEATHER L (NP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:DANIEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 TAUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-2707
Mailing Address - Country:US
Mailing Address - Phone:508-285-9500
Mailing Address - Fax:508-285-3388
Practice Address - Street 1:14 TAUNTON AVE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-2707
Practice Address - Country:US
Practice Address - Phone:508-285-9500
Practice Address - Fax:508-285-3388
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261310363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000911001Medicare PIN
MA000911002Medicare PIN