Provider Demographics
NPI:1891057113
Name:SMITH, DANIELLE MELISSA (APRN, CNM)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MELISSA
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N INTERVALE ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03064-2513
Mailing Address - Country:US
Mailing Address - Phone:603-759-7436
Mailing Address - Fax:
Practice Address - Street 1:61 SPIT BROOK RD STE 202
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5614
Practice Address - Country:US
Practice Address - Phone:603-821-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH054757-23363LF0000X, 367A00000X, 363LP0808X
MARN264291363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife