Provider Demographics
NPI:1114289238
Name:KOMAN, DANIELLE RAE (DNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RAE
Last Name:KOMAN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:RAE
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:777 CASINO DR
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719-9761
Mailing Address - Country:US
Mailing Address - Phone:828-497-8642
Mailing Address - Fax:828-497-8832
Practice Address - Street 1:777 CASINO DR
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719-9761
Practice Address - Country:US
Practice Address - Phone:828-497-8642
Practice Address - Fax:828-497-8832
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005657363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC255194OtherRN
NC5005657OtherNURSE PRACTITIONER
NC5005657OtherNURSE PRACTITIONER