Provider Demographics
NPI:1104109859
Name:VANN, DANIELLE R (DC)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:R
Last Name:VANN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:620 VETERANS PARKWAY
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-5803
Mailing Address - Country:US
Mailing Address - Phone:919-977-5744
Mailing Address - Fax:919-977-6320
Practice Address - Street 1:5176 NC HIGHWAY 42 W
Practice Address - Street 2:STE. A
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-8471
Practice Address - Country:US
Practice Address - Phone:919-977-5744
Practice Address - Fax:919-977-6320
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556907111N00000X
NC4197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCR921G655Medicare PIN