Individual
ASHA DANIELLA INNISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1604 HOSPITAL PKWY STE 200, BEDFORD, TX 76022-6930
(817) 848-4485
Mailing address
9201 E MOUNTAIN VEW ROAD, 220, SCOTTDALE, AZ 85258
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP131436
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
AP131436
TX
Other
Enumeration date
08/19/2016
Last updated
08/24/2023
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