Provider Demographics
NPI:1821222639
Name:LAMPART, DANIELLE LE (CPHT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LE
Last Name:LAMPART
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:LE
Other - Last Name:DETLEFSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 4TH ST
Mailing Address - Street 2:
Mailing Address - City:TWO HARBORS
Mailing Address - State:MN
Mailing Address - Zip Code:55616-1200
Mailing Address - Country:US
Mailing Address - Phone:218-834-7202
Mailing Address - Fax:
Practice Address - Street 1:1010 4TH ST
Practice Address - Street 2:
Practice Address - City:TWO HARBORS
Practice Address - State:MN
Practice Address - Zip Code:55616-1200
Practice Address - Country:US
Practice Address - Phone:218-834-7202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN703850183700000X
MN4201-0107-1252-411183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician