Individual provider Active NPI

Jill Brannan Danielson, N.P.

  • Family Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1396037057
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN060090 Issued in GA
Practice address
631 Professional Dr
Suite 360
Lawrenceville, GA 30046-3367
Phone
(770) 962-4895
Fax
(770) 962-4792
NPI assigned
May 12, 2011
Last updated
Mar 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN060090 GA Primary

Addresses

Primary practice location

631 Professional Dr
Suite 360
Lawrenceville, GA 30046-3367

Mailing address

631 Professional Dr
Ste 360
Lawrenceville, GA 30046-3367
Phone (404) 235-6822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1396037057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR",
            "address_2": "STE 360",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463367",
            "telephone_number": "404-235-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR",
            "address_2": "SUITE 360",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463367",
            "telephone_number": "770-962-4895",
            "fax_number": "770-962-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSON",
        "first_name": "JILL",
        "middle_name": "BRANNAN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN060090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.