Individual
DANAE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
15264 W BROOKSIDE LN STE 155, SURPRISE, AZ 85374-3997
(623) 877-7337
(623) 772-0686
Mailing address
4137 N 108TH AVE, PHOENIX, AZ 85037-5459
(623) 877-7337
(623) 772-0686
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
009185
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2018
Last updated
09/09/2021
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