Provider Demographics
NPI:1235267790
Name:BANGS, DANIELLE E (RN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:E
Last Name:BANGS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 MOUNTAIN VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:RAWLINS
Mailing Address - State:WY
Mailing Address - Zip Code:82301-4659
Mailing Address - Country:US
Mailing Address - Phone:307-324-4445
Mailing Address - Fax:307-324-4445
Practice Address - Street 1:1317 MOUNTAIN VIEW BLVD
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-4659
Practice Address - Country:US
Practice Address - Phone:307-324-4445
Practice Address - Fax:307-324-4445
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY11689800251C00000X
WY218783747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant