Doctor Name: | MRS. KARI JO DANIELS |
NPI Number: | 1003922345 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C MPAS |
License Number: | 000840 |
Business Practice Address: | 561 Talcottville Rd Vernon, CT - 060662311 |
Business Phone Number: | 8608712016 |
Business Fax Number: | 8608719329 |
Mailing Address: | 561 Talcottville Rd, VERNON |
State: | CT |
Postal Code: | 06066 |
Phone Number: | 8608712016 |
Fax Number: | 8608719329 |
NPI Enumeration Date: | 08/21/2006 |
NPI Last Update Date: | 12/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 000840 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |