Individual
MRS. HARLEY DANIELLE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 355-2750
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
28250876A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71012677A
IN
Other
Enumeration date
05/23/2022
Last updated
08/30/2022
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