Provider Demographics
NPI:1760472542
Name:STANTON, DANNY LEE (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:LEE
Last Name:STANTON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 CHERRYSTONE DR S
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-2180
Mailing Address - Country:US
Mailing Address - Phone:614-209-9924
Mailing Address - Fax:614-478-6049
Practice Address - Street 1:287 CHERRYSTONE DR S
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-2180
Practice Address - Country:US
Practice Address - Phone:614-209-9924
Practice Address - Fax:614-478-6049
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 215199207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0755740Medicaid
OH0755740Medicaid
S00133Medicare UPIN