Provider Demographics
NPI:1669222485
Name:CURLISS, DANERYL
Entity type:Individual
Prefix:
First Name:DANERYL
Middle Name:
Last Name:CURLISS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7245 N SUMMER WALK WAY
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86315-3060
Mailing Address - Country:US
Mailing Address - Phone:928-848-9888
Mailing Address - Fax:
Practice Address - Street 1:7245 N SUMMER WALK WAY
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86315-3060
Practice Address - Country:US
Practice Address - Phone:928-848-9888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist