Provider Demographics
NPI:1669445854
Name:DUVAL, DANIELLE JACQUELINE (ARNP-C)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:JACQUELINE
Last Name:DUVAL
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 MASON BAY RD
Mailing Address - Street 2:
Mailing Address - City:JONESPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04649-3501
Mailing Address - Country:US
Mailing Address - Phone:207-497-2996
Mailing Address - Fax:
Practice Address - Street 1:5401 S CONGRESS AVE STE 102
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6636
Practice Address - Country:US
Practice Address - Phone:561-967-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005032856363L00000X
MER054382363LA2200X
FL2683923363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOQ58254Medicare UPIN
MO828124342Medicare PIN
FLAD402ZMedicare PIN