Provider Demographics
NPI:1629206370
Name:DEUTSCHENDORF, DANIELLE JULIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:JULIA
Last Name:DEUTSCHENDORF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 MDG/SGOF
Mailing Address - Street 2:UNIT 3865
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09126-3865
Mailing Address - Country:US
Mailing Address - Phone:49656-561-8169
Mailing Address - Fax:
Practice Address - Street 1:377 MDG
Practice Address - Street 2:2050A SECOND STREET SE
Practice Address - City:KIRTLAND AFB
Practice Address - State:NM
Practice Address - Zip Code:87117-5522
Practice Address - Country:US
Practice Address - Phone:505-846-3379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM67988163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care