Provider Demographics
NPI:1780227751
Name:TANQUE, DANIELLE MARIE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:MARIE
Last Name:TANQUE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 QUARRY STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723-1007
Mailing Address - Country:US
Mailing Address - Phone:508-679-8111
Mailing Address - Fax:
Practice Address - Street 1:387 QUARRY STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1007
Practice Address - Country:US
Practice Address - Phone:508-679-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2269821207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine