Provider Demographics
NPI:1285921312
Name:VANHOOSE, DANIEL LEE (APRN)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:LEE
Last Name:VANHOOSE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4190
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-4190
Mailing Address - Country:US
Mailing Address - Phone:304-908-9201
Mailing Address - Fax:304-935-3334
Practice Address - Street 1:2827 5TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1435
Practice Address - Country:US
Practice Address - Phone:304-399-7182
Practice Address - Fax:304-523-7738
Is Sole Proprietor?:No
Enumeration Date:2011-07-10
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006910363LF0000X
WV68999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100177770Medicaid
KYK012731Medicare PIN
KYK012733Medicare PIN
KYK012730Medicare PIN
KY7100177770Medicaid
KYK012732Medicare PIN