Provider Demographics
NPI:1356837744
Name:BRANNAN, DANIELLE ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:BRANNAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:ELIZABETH
Other - Last Name:ROCHEFORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1725 DOUGLAS TPKE
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02830-1683
Mailing Address - Country:US
Mailing Address - Phone:401-487-9064
Mailing Address - Fax:
Practice Address - Street 1:594 GREAT RD STE 102
Practice Address - Street 2:
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-6810
Practice Address - Country:US
Practice Address - Phone:401-768-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA01062363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant