Provider Demographics
NPI:1851435994
Name:ROSE, DANIELLE LYNN (NP-C)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:LYNN
Last Name:ROSE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1302
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69363-1302
Mailing Address - Country:US
Mailing Address - Phone:970-372-8754
Mailing Address - Fax:
Practice Address - Street 1:8031 CAMPUS DELIVERY
Practice Address - Street 2:CSU-HARTSHORN HEALTH CENTER
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-8031
Practice Address - Country:US
Practice Address - Phone:970-491-1735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE113145363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily