Provider Demographics
NPI:1154142743
Name:DANIELS, TONNA SHANAE (NP)
Entity type:Individual
Prefix:MRS
First Name:TONNA
Middle Name:SHANAE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 KINGWOOD MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6405
Mailing Address - Country:US
Mailing Address - Phone:713-730-2229
Mailing Address - Fax:
Practice Address - Street 1:350 KINGWOOD MEDICAL DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6405
Practice Address - Country:US
Practice Address - Phone:325-356-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX983388163WR1000X
TX1180822363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WR1000XNursing Service ProvidersRegistered NurseReproductive Endocrinology/Infertility