Provider Demographics
NPI:1750648044
Name:DEINES, DANIELLE ALEXIS (DO)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ALEXIS
Last Name:DEINES
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2211 LOMAS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2719
Mailing Address - Country:US
Mailing Address - Phone:828-712-4555
Mailing Address - Fax:
Practice Address - Street 1:310 SUNNYVIEW LN
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3129
Practice Address - Country:US
Practice Address - Phone:406-751-5391
Practice Address - Fax:406-751-2988
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2024-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01022052842080N0001X
NMDO2022-00072080N0001X, 2080N0001X
MT1035402080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine