Provider Demographics
NPI:1437793155
Name:HALE, DANIELLE LYN
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LYN
Last Name:HALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 N SCOTTSDALE RD STE D
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-4207
Mailing Address - Country:US
Mailing Address - Phone:480-990-3720
Mailing Address - Fax:
Practice Address - Street 1:617 N SCOTTSDALE RD STE D
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-4207
Practice Address - Country:US
Practice Address - Phone:480-990-3720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP048924164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse