Provider Demographics
NPI:1437523214
Name:LEMKE, DANIELLE LEE (MED, LAT)
Entity Type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:LEE
Last Name:LEMKE
Suffix:
Gender:F
Credentials:MED, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W4793 SCHONFELD LN
Mailing Address - Street 2:
Mailing Address - City:PESHTIGO
Mailing Address - State:WI
Mailing Address - Zip Code:54157-9696
Mailing Address - Country:US
Mailing Address - Phone:920-373-3226
Mailing Address - Fax:
Practice Address - Street 1:W4793 SCHONFELD LN
Practice Address - Street 2:
Practice Address - City:PESHTIGO
Practice Address - State:WI
Practice Address - Zip Code:54157-9696
Practice Address - Country:US
Practice Address - Phone:920-373-3226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1312-392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000002358OtherBOARD OF CERTIFICATION - ATHLETIC TRAINING
WI1312-39OtherWISCONSIN STATE LICENSURE