Individual
CARRIE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3301 COUNTY ROAD 6 E, ELKHART, IN 46514-7673
(574) 264-9635
(574) 262-0398
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71005105A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000895822
BCBS BMG ELKHART
IN
05
—
201253830
—
IN
01
—
P01407944
RR MEDICARE
IN
Enumeration date
08/20/2014
Last updated
03/31/2021
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