Provider Demographics
NPI:1073862868
Name:HENLEY, DANIELLE LEE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:LEE
Last Name:HENLEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6312 MICHAEL SHANE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-4874
Mailing Address - Country:US
Mailing Address - Phone:866-308-9925
Mailing Address - Fax:870-741-4784
Practice Address - Street 1:724 N SPRING ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2913
Practice Address - Country:US
Practice Address - Phone:866-308-9925
Practice Address - Fax:870-741-4784
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARL50828164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse