Provider Demographics
NPI:1114458882
Name:MILLSPAUGH, DANIELLE REBECCA (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:REBECCA
Last Name:MILLSPAUGH
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:DR
Other - First Name:DANIELLA
Other - Middle Name:REBECCA
Other - Last Name:MILLSPAUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP, FNP-C
Mailing Address - Street 1:110 BEVERLY AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-4420
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3960 VIRGINIA BEACH BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2449
Practice Address - Country:US
Practice Address - Phone:757-668-8464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174675363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily