Provider Demographics
NPI:1932572997
Name:RUIZ, DANIELLE ALEXANDRA (MSN, APRN, AGNP-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ALEXANDRA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MSN, APRN, AGNP-C
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:ALEXANDRA
Other - Last Name:GOBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8065 LEESBURG PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2746
Mailing Address - Country:US
Mailing Address - Phone:866-383-7888
Mailing Address - Fax:571-400-2353
Practice Address - Street 1:8065 LEESBURG PIKE STE 100
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2746
Practice Address - Country:US
Practice Address - Phone:866-383-7888
Practice Address - Fax:571-400-2353
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-12
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001227829163WG0000X
VA0024179551363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology