Provider Demographics
NPI:1083105860
Name:HANNIGAN, DANIELLE (DIRECTOR OF NURSING)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:HANNIGAN
Suffix:
Gender:F
Credentials:DIRECTOR OF NURSING
Other - Prefix:MR
Other - First Name:DAMIEN
Other - Middle Name:
Other - Last Name:THORNTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DIR OF OPERATIONS
Mailing Address - Street 1:6 FRANKLIN ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-3005
Mailing Address - Country:US
Mailing Address - Phone:508-521-3080
Mailing Address - Fax:617-412-3004
Practice Address - Street 1:529 MAIN ST STE 243
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-1125
Practice Address - Country:US
Practice Address - Phone:617-870-1676
Practice Address - Fax:617-412-3004
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA254108163WG0000X, 163WI0500X, 163WM0705X, 163WN1003X, 163WW0000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WW0000XNursing Service ProvidersRegistered NurseWound Care