Provider Demographics
NPI:1821532128
Name:KISTER, DANIELLE HAYES (RN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:HAYES
Last Name:KISTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:HAYES
Other - Last Name:KISTER-ROUNDHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1050 S JEFFERSON DAVIS PKWY
Mailing Address - Street 2:SUITE 212
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-1200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1050 S JEFFERSON DAVIS PKWY
Practice Address - Street 2:SUITE 212
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-1200
Practice Address - Country:US
Practice Address - Phone:504-821-7233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN139293163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult