Provider Demographics
NPI:1205232097
Name:LAFOLLETTE, DANIELLE MAREENE (RN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MAREENE
Last Name:LAFOLLETTE
Suffix:
Gender:F
Credentials:RN
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 25
Mailing Address - Street 2:
Mailing Address - City:WARDENSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26851-0025
Mailing Address - Country:US
Mailing Address - Phone:540-335-9701
Mailing Address - Fax:
Practice Address - Street 1:494 N MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1703
Practice Address - Country:US
Practice Address - Phone:540-459-5180
Practice Address - Fax:540-459-4067
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001242405163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult