Individual
MS. DANIELLE O. HUMPHREYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
235 MEDICAL PARK BLVD, BRISTOL, TN 37620-7455
(423) 246-6777
(423) 246-7766
Mailing address
135 W RAVINE RD, SUITE 3A, KINGSPORT, TN 37660-3847
(423) 246-6777
(423) 746-7766
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN08353
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010316634
—
VA
05
—
3700035
—
TN
01
—
4212285
BCBS
TN
Enumeration date
01/26/2006
Last updated
02/13/2020
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