Provider Demographics
NPI:1124579792
Name:FESTA, DANIELLE M (CRNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:M
Last Name:FESTA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 ROUTE 113
Mailing Address - Street 2:
Mailing Address - City:SOUDERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18964-1000
Mailing Address - Country:US
Mailing Address - Phone:215-723-3280
Mailing Address - Fax:215-723-5503
Practice Address - Street 1:1107 EATON AVE STE F
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-1862
Practice Address - Country:US
Practice Address - Phone:484-526-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016669363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily