Provider Demographics
NPI:1285919084
Name:SIMONSON, DANIELLE (ACNP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:SIMONSON
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 14TH ST
Mailing Address - Street 2:APT 1
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-3020
Mailing Address - Country:US
Mailing Address - Phone:518-361-0795
Mailing Address - Fax:
Practice Address - Street 1:124 ROSA RD
Practice Address - Street 2:SUITE 382
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2143
Practice Address - Country:US
Practice Address - Phone:518-386-3691
Practice Address - Fax:518-386-3694
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430624-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care