Provider Demographics
NPI:1154901155
Name:KING, DANIELLE NICOLE (APRN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:NICOLE
Last Name:KING
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 1:1400 S ARLINGTON ST UNIT 38
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-3771
Mailing Address - Country:US
Mailing Address - Phone:888-975-9188
Mailing Address - Fax:
Practice Address - Street 1:1400 S ARLINGTON ST UNIT 38
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-3771
Practice Address - Country:US
Practice Address - Phone:888-975-9188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028458363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily