Provider Demographics
NPI:1003287434
Name:PURI, DANIELLE RENEE (ARNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RENEE
Last Name:PURI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:RENEE
Other - Last Name:KNOEPFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:3448 WEST 3200 SOUTH
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119
Mailing Address - Country:US
Mailing Address - Phone:801-359-2256
Mailing Address - Fax:801-364-4392
Practice Address - Street 1:3448 WEST 3200 SOUTH
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119
Practice Address - Country:US
Practice Address - Phone:801-359-2256
Practice Address - Fax:801-364-4392
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11140002-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily