Provider Demographics
NPI:1598950768
Name:STAECKER, DANIELLE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:STAECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 411851
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-1851
Mailing Address - Country:US
Mailing Address - Phone:913-588-6201
Mailing Address - Fax:913-588-6271
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:MAILSTOP 2028
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-6201
Practice Address - Fax:913-588-6271
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST01519207V00000X
KS0432764207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology