Provider Demographics
NPI:1629629324
Name:PARE, DANIELLE M (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:M
Last Name:PARE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:MEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:1000 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IL
Mailing Address - Zip Code:61856-2116
Mailing Address - Country:US
Mailing Address - Phone:217-762-6241
Mailing Address - Fax:217-762-1702
Practice Address - Street 1:100 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:ATWOOD
Practice Address - State:IL
Practice Address - Zip Code:61913-7233
Practice Address - Country:US
Practice Address - Phone:217-578-3814
Practice Address - Fax:217-578-3100
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001739363LF0000X
IL209019025363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNO INSURER