Provider Demographics
NPI:1114594918
Name:PARKER, DANIELLE NICOLE (RN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:NICOLE
Last Name:PARKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1552 STRAWTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IN
Mailing Address - Zip Code:46970-2773
Mailing Address - Country:US
Mailing Address - Phone:765-472-8049
Mailing Address - Fax:765-475-8895
Practice Address - Street 1:269 MEADOWVIEW DR
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-8996
Practice Address - Country:US
Practice Address - Phone:765-472-8049
Practice Address - Fax:765-475-8895
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28189228A163W00000X, 364SL0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term Care
No163W00000XNursing Service ProvidersRegistered Nurse