Provider Demographics
NPI:1942069687
Name:GREEN- BROWN, DANIELLE RENEE (REGISTERED NURSE, RN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RENEE
Last Name:GREEN- BROWN
Suffix:
Gender:F
Credentials:REGISTERED NURSE, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CRYSTAL HILL DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2670
Mailing Address - Country:US
Mailing Address - Phone:929-227-1618
Mailing Address - Fax:
Practice Address - Street 1:103 CRYSTAL HILL DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-2670
Practice Address - Country:US
Practice Address - Phone:929-227-1618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY709449163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse