Provider Demographics
NPI:1467798694
Name:PARKER, DANIELLE C (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:C
Last Name:PARKER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 UNION ST
Mailing Address - Street 2:APT 2
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-2908
Mailing Address - Country:US
Mailing Address - Phone:607-745-5607
Mailing Address - Fax:
Practice Address - Street 1:38 UNION ST
Practice Address - Street 2:APT 2
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-2908
Practice Address - Country:US
Practice Address - Phone:607-745-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-16
Last Update Date:2012-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312588-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse