Provider Demographics
NPI:1770954836
Name:MCDONOUGH, DANIELLE E (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:E
Last Name:MCDONOUGH
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 BERGLUND LN
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6474
Mailing Address - Country:US
Mailing Address - Phone:321-421-7525
Mailing Address - Fax:321-622-6860
Practice Address - Street 1:1706 BERGLUND LN
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-6474
Practice Address - Country:US
Practice Address - Phone:321-421-7525
Practice Address - Fax:321-622-6860
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9262691363LF0000X
FLARNP9262691363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily