Provider Demographics
NPI:1083782361
Name:THREATS, DANIELLE (DNP)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:
Last Name:THREATS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6142 FOUNTAIN POINTE
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7753
Mailing Address - Country:US
Mailing Address - Phone:313-399-2361
Mailing Address - Fax:
Practice Address - Street 1:6142 FOUNTAIN POINTE
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-7753
Practice Address - Country:US
Practice Address - Phone:313-399-2361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX191752164X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No164X00000XNursing Service ProvidersLicensed Vocational Nurse