Provider Demographics
NPI:1811366008
Name:CROCE, DANIELLE (RN, IBCLC)
Entity Type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:
Last Name:CROCE
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:MCDARRAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1831 BOULDER SPRINGS DR
Mailing Address - Street 2:APT. I
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-3953
Mailing Address - Country:US
Mailing Address - Phone:630-470-5154
Mailing Address - Fax:
Practice Address - Street 1:1831 BOULDER SPRINGS DR
Practice Address - Street 2:APT. I
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3953
Practice Address - Country:US
Practice Address - Phone:630-470-5154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILL-69207163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant