Provider Demographics
NPI:1255144218
Name:KING, DANIELLE LOUISE (RN)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:LOUISE
Last Name:KING
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 1:245 RIPON ST SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-5278
Mailing Address - Country:US
Mailing Address - Phone:319-929-9201
Mailing Address - Fax:
Practice Address - Street 1:5005 BOWLING ST SW STE C
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-5070
Practice Address - Country:US
Practice Address - Phone:319-249-5213
Practice Address - Fax:319-531-3840
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA115625163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse