Provider Demographics
NPI:1346429024
Name:HARRIS, DANICA VALTEAU (APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:DANICA
Middle Name:VALTEAU
Last Name:HARRIS
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2269 MUSTANG TRL
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-8379
Mailing Address - Country:US
Mailing Address - Phone:214-546-4579
Mailing Address - Fax:
Practice Address - Street 1:8144 WALNUT HILL LN STE 1100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4345
Practice Address - Country:US
Practice Address - Phone:214-313-9693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX639835363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K5864Medicare PIN