Provider Demographics
NPI:1811681992
Name:JONES, DANIELLE RAE (RN, BSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:RAE
Last Name:JONES
Suffix:
Gender:F
Credentials:RN, BSN, FNP-C
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:DUDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2115 S FREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-2239
Mailing Address - Country:US
Mailing Address - Phone:417-820-5200
Mailing Address - Fax:
Practice Address - Street 1:2115 S FREMONT AVE STE 3300
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2246
Practice Address - Country:US
Practice Address - Phone:417-820-2506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023020398363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily