Provider Demographics
NPI:1104656925
Name:WOOD, DANIELLE HILLARY
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:HILLARY
Last Name:WOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 N 600 W
Mailing Address - Street 2:
Mailing Address - City:WEST BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84087-1283
Mailing Address - Country:US
Mailing Address - Phone:801-712-2887
Mailing Address - Fax:
Practice Address - Street 1:630 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4908
Practice Address - Country:US
Practice Address - Phone:801-299-2172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8293913-3102163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant