Individual
DANIELLE LYNN SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
421 S COLLEGE AVE, BLOOMINGTON, IN 47403-1592
(812) 670-9087
Mailing address
421 S COLLEGE AVE, BLOOMINGTON, IN 47403-1514
(812) 670-9087
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
71011130A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71011130A
APRN
IN
Enumeration date
01/30/2019
Last updated
05/31/2022
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