Provider Demographics
NPI:1225892458
Name:CHENG, DANIELLE LEIGH (AGPCNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:LEIGH
Last Name:CHENG
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 578
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MI
Mailing Address - Zip Code:49665-0578
Mailing Address - Country:US
Mailing Address - Phone:231-743-0150
Mailing Address - Fax:231-743-0152
Practice Address - Street 1:100 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MI
Practice Address - Zip Code:49665-9239
Practice Address - Country:US
Practice Address - Phone:231-743-0150
Practice Address - Fax:231-743-0152
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704307921207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine