Provider Demographics
NPI:1619320272
Name:BARNES, DANIELLE MARIE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:BARNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:593 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:SUSQUEHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18847-1307
Mailing Address - Country:US
Mailing Address - Phone:570-853-2724
Mailing Address - Fax:
Practice Address - Street 1:593 PROSPECT STREET
Practice Address - Street 2:
Practice Address - City:SUSQUEHANNA
Practice Address - State:PENNSYLVANIA
Practice Address - Zip Code:18847
Practice Address - Country:UM
Practice Address - Phone:570-853-2724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program