Jessica Daniels
Individual provider Active NPI Athletic Trainer · Ennis, TX
NPI 1720418643 · NPPES record last updated Nov 13, 2013
Key facts
- NPI
- 1720418643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT5138 (TX)
- Practice address
- 2401 Yorkstown Dr Apt 221
Ennis, TX 75119-3618 - Phone
- (859) 466-4008
- NPI assigned
- Nov 13, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT5138 | TX | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT5138 | TX | Yes |
Addresses
Primary practice location
2401 Yorkstown Dr Apt 221
Ennis, TX 75119-3618
Mailing address
2401 Yorkstown Dr Apt 221
Ennis, TX 75119-3618
Phone (859) 466-4008
Other providers in Ennis, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.