Provider Demographics
NPI:1750766796
Name:PRICE, DANIELLE ELISA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:ELISA
Last Name:PRICE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:ELISA
Other - Last Name:CORTESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11350 MCCORMICK RD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-1002
Mailing Address - Country:US
Mailing Address - Phone:301-777-2543
Mailing Address - Fax:301-777-2583
Practice Address - Street 1:940 SETON DR
Practice Address - Street 2:SUITE A
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1818
Practice Address - Country:US
Practice Address - Phone:301-777-2543
Practice Address - Fax:301-777-2583
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05847363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical