Provider Demographics
NPI:1316171655
Name:ZACHARY, DANIELLE N (CNS)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:N
Last Name:ZACHARY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 W MEMORIAL RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-2006
Mailing Address - Country:US
Mailing Address - Phone:405-418-5400
Mailing Address - Fax:405-418-5401
Practice Address - Street 1:609 W MEMORIAL RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-2006
Practice Address - Country:US
Practice Address - Phone:405-418-5400
Practice Address - Fax:405-418-5401
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR 80480364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist