Individual
DANIELLE NICOLE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1461 MORTHLAND DR STE A, VALPARAISO, IN 46385-6362
(219) 663-4007
(219) 703-6855
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02005756A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300029260
—
IN
Enumeration date
04/13/2016
Last updated
03/08/2021
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