Provider Demographics
NPI:1093729162
Name:MAHONEY, DANIELLE L (ARNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:L
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:L
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 2200
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-4200
Mailing Address - Country:US
Mailing Address - Phone:603-673-9411
Mailing Address - Fax:603-673-9899
Practice Address - Street 1:74 ALLDS ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-4757
Practice Address - Country:US
Practice Address - Phone:603-886-5506
Practice Address - Fax:603-594-2585
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH056692-21163W00000X
MA253394163W00000X
NH0566912303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHAA68164OtherHARVARD PILGRIM
NHNP5425Medicare ID - Type Unspecified