Provider Demographics
NPI:1073210407
Name:HAYGOOD, DANIELLE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:HAYGOOD
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1765 FOLSOM RD SE
Mailing Address - Street 2:
Mailing Address - City:RYDAL
Mailing Address - State:GA
Mailing Address - Zip Code:30171-1753
Mailing Address - Country:US
Mailing Address - Phone:678-767-1303
Mailing Address - Fax:
Practice Address - Street 1:1900 THE EXCHANGE SE STE 600
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2050
Practice Address - Country:US
Practice Address - Phone:770-291-8987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN143272363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner