Provider Demographics
NPI:1568088177
Name:GOOLSBY, DANIELLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:GOOLSBY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 HWY 111
Mailing Address - Street 2:
Mailing Address - City:BYRDSTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38549-1006
Mailing Address - Country:US
Mailing Address - Phone:931-864-3187
Mailing Address - Fax:931-864-7102
Practice Address - Street 1:8401 HWY 111
Practice Address - Street 2:
Practice Address - City:BYRDSTOWN
Practice Address - State:TN
Practice Address - Zip Code:38549-1006
Practice Address - Country:US
Practice Address - Phone:931-864-3187
Practice Address - Fax:931-864-7102
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27727363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN27727OtherTN FNP LICENSE NUMBER