Provider Demographics
NPI:1407300452
Name:GRATTON, DANIELLE (RN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:GRATTON
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 1:151 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4715
Mailing Address - Country:US
Mailing Address - Phone:701-787-8100
Mailing Address - Fax:701-787-8145
Practice Address - Street 1:151 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4715
Practice Address - Country:US
Practice Address - Phone:701-787-8100
Practice Address - Fax:701-787-8145
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR28085163W00000X
MNR162874-0163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse