Provider Demographics
NPI:1669924817
Name:LEEPER, DANIELLE (CNP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:LEEPER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 VALMAR ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5763
Mailing Address - Country:US
Mailing Address - Phone:501-920-6554
Mailing Address - Fax:
Practice Address - Street 1:1 SAINT VINCENT CIR
Practice Address - Street 2:SUITE 160
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5405
Practice Address - Country:US
Practice Address - Phone:501-661-0037
Practice Address - Fax:501-661-0038
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004951363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner