Provider Demographics
NPI:1992024244
Name:LAFERRIERE, DANIELLE KELLY (LPN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:KELLY
Last Name:LAFERRIERE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BLENOR AVENUE
Mailing Address - Street 2:
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839
Mailing Address - Country:US
Mailing Address - Phone:518-747-2121
Mailing Address - Fax:
Practice Address - Street 1:18 BLENOR AVE
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-9656
Practice Address - Country:US
Practice Address - Phone:518-747-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219276164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse