Provider Demographics
NPI:1861726093
Name:CERVANTES-ELIA, DANIELA (RN BSN MSN FNP)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:CERVANTES-ELIA
Suffix:
Gender:F
Credentials:RN BSN MSN FNP
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:
Other - Last Name:CERVANTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN FNP
Mailing Address - Street 1:51544 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-1501
Mailing Address - Country:US
Mailing Address - Phone:760-398-3555
Mailing Address - Fax:
Practice Address - Street 1:88775 AVENUE 76, STE. 1
Practice Address - Street 2:
Practice Address - City:THERMAL
Practice Address - State:CA
Practice Address - Zip Code:92274-9407
Practice Address - Country:US
Practice Address - Phone:760-397-2501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA580301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily