Provider Demographics
NPI:1841965936
Name:BOARD, DANIELLE N (APRN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:N
Last Name:BOARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3080 STEEPLECHASE
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4408
Mailing Address - Country:US
Mailing Address - Phone:270-929-3280
Mailing Address - Fax:
Practice Address - Street 1:452 OLD CORYDON RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-4645
Practice Address - Country:US
Practice Address - Phone:270-826-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016496363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily