Provider Demographics
NPI:1780983916
Name:WESTGATE, DANIELLE LAURIE (CRNP, MS, PMHNP)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:LAURIE
Last Name:WESTGATE
Suffix:
Gender:F
Credentials:CRNP, MS, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-2707
Mailing Address - Country:US
Mailing Address - Phone:570-344-1115
Mailing Address - Fax:
Practice Address - Street 1:1509 MAPLE ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-2707
Practice Address - Country:US
Practice Address - Phone:570-344-1115
Practice Address - Fax:570-281-6336
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014583363LP0808X
FLARNP9255349363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFK852ZMedicare UPIN