Provider Demographics
NPI:1417321779
Name:CRAIG, DANIELLE STORY (NP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:STORY
Last Name:CRAIG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 VOLUNTEER DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-5472
Mailing Address - Country:US
Mailing Address - Phone:731-642-2535
Mailing Address - Fax:
Practice Address - Street 1:800 VOLUNTEER DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-5472
Practice Address - Country:US
Practice Address - Phone:731-642-2535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013269363LA2200X
TN20621363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health