Provider Demographics
NPI:1295435535
Name:ATKINS, DANELLE MARIE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:DANELLE
Middle Name:MARIE
Last Name:ATKINS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3394 HAYES RD
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-9447
Mailing Address - Country:US
Mailing Address - Phone:315-638-0142
Mailing Address - Fax:
Practice Address - Street 1:3394 HAYES RD
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-9447
Practice Address - Country:US
Practice Address - Phone:315-638-0142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY418616-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse