Individual
DANIELLE RENEE EDDINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
618 N BENTON AVE, SPRINGFIELD, MO 65806-1102
(417) 851-1563
(417) 831-8033
Mailing address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
(417) 831-8033
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
111620
IA
163W00000X
Registered Nurse
759723
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2016038313
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2013002449
STATE LICENSE
MO
05
—
420037252
—
MO
Enumeration date
10/13/2009
Last updated
10/29/2018
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