Provider Demographics
NPI:1427140409
Name:MCPHERSON, DANIELLE (FNP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:FNP
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 997
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58502-0997
Mailing Address - Country:US
Mailing Address - Phone:701-530-7000
Mailing Address - Fax:
Practice Address - Street 1:2500 SUNSET DR
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-1540
Practice Address - Country:US
Practice Address - Phone:701-667-4600
Practice Address - Fax:701-530-3780
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR25501363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1451787Medicaid
ND1451787Medicaid
Q72335Medicare UPIN
NDP00349831OtherRR MEDICARE
NDN712176Medicare PIN