Provider Demographics
NPI:1033394044
Name:WARREN, DANIELLE (PA)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10215 KINGSTON PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3492
Mailing Address - Country:US
Mailing Address - Phone:865-584-8580
Mailing Address - Fax:865-251-9961
Practice Address - Street 1:10215 KINGSTON PIKE STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3492
Practice Address - Country:US
Practice Address - Phone:865-584-8580
Practice Address - Fax:865-251-9961
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA576363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant