Basic Information
Provider Information
NPI: 1821506080
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHRICK
FirstName: DANIELLE
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DOBRATZ
OtherFirstName: DANIELLE
OtherMiddleName: C
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PA
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 741331
Address2:  
City: ATLANTA
State: GA
PostalCode: 303741331
CountryCode: US
TelephoneNumber: 9134690503
FaxNumber: 9134695267
Practice Location
Address1: 10600 MASTIN ST
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662125723
CountryCode: US
TelephoneNumber: 9134380868
FaxNumber: 9133381311
Other Information
ProviderEnumerationDate: 01/22/2018
LastUpdateDate: 04/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X15-02070KSY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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