Provider Demographics
NPI:1972240950
Name:BROWN, DANIELLE CONNOLLY (FNP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CONNOLLY
Last Name:BROWN
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-2298
Mailing Address - Country:US
Mailing Address - Phone:805-239-2159
Mailing Address - Fax:
Practice Address - Street 1:612 SPRING ST STE 202
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446
Practice Address - Country:US
Practice Address - Phone:805-239-2159
Practice Address - Fax:820-345-0429
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020668363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily