Provider Demographics
NPI:1982060059
Name:SHOOTS, DANIEL PAUL (RN)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:SHOOTS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 OAKWOOD EST
Mailing Address - Street 2:
Mailing Address - City:DUNDEE
Mailing Address - State:NY
Mailing Address - Zip Code:14837-1153
Mailing Address - Country:US
Mailing Address - Phone:315-521-1866
Mailing Address - Fax:
Practice Address - Street 1:6 OAKWOOD EST
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:NY
Practice Address - Zip Code:14837-1153
Practice Address - Country:US
Practice Address - Phone:315-521-1866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY704976163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse