Edson, Daniela M

Edson, Daniela M is an individual health care provider with primary practice located at 621 Memorial Dr Ste 502 , South Bend IN 46601-1075. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Edson, Daniela M can be contacted via phone (574) 647-5875.

Contact Information

Primary practice address
621 Memorial Dr Ste 502 South Bend IN 46601-1075
Phone: (574) 647-5875
Fax: (574) 647-5878
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 71008852A Indiana

Profile Details

NPI number 1447721105
LBN Legal business name Edson, Daniela M
Credentials AGACNP, NP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2018
Last updated Mar 14th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447721105 NPPES
Indiana MEDICAID 300024411

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