Provider Demographics
NPI:1629641667
Name:O'GARRA, DANIELLE GLANTON (RN)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:GLANTON
Last Name:O'GARRA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 ROYCE DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-9911
Mailing Address - Country:US
Mailing Address - Phone:757-535-8963
Mailing Address - Fax:
Practice Address - Street 1:301 ROYCE DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27107-9911
Practice Address - Country:US
Practice Address - Phone:757-535-8963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332557163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health