Provider Demographics
NPI:1790384279
Name:BROWN, DANIELL LAVINAH (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:DANIELL
Middle Name:LAVINAH
Last Name:BROWN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:9375 E SHEA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6986
Mailing Address - Country:US
Mailing Address - Phone:480-360-0388
Mailing Address - Fax:480-900-8782
Practice Address - Street 1:9375 E SHEA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6986
Practice Address - Country:US
Practice Address - Phone:480-360-0388
Practice Address - Fax:480-900-8782
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-25
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016408363LP0808X
OR10001250363LP0808X
AZ282708363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty