Provider Demographics
NPI:1083002646
Name:SOVEY, DANIELLE NICOLE (NP-BC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:NICOLE
Last Name:SOVEY
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:NICOLE
Other - Last Name:KITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2076 WOVEN HEART DR
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-1093
Mailing Address - Country:US
Mailing Address - Phone:517-896-4285
Mailing Address - Fax:
Practice Address - Street 1:1200 E. MICHIGAN AVE.
Practice Address - Street 2:SUITE 580
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912
Practice Address - Country:US
Practice Address - Phone:517-483-7550
Practice Address - Fax:517-483-8436
Is Sole Proprietor?:No
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704276054363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily