Provider Demographics
NPI:1346836541
Name:NJERI, DANIELLE BIANCA (NP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:BIANCA
Last Name:NJERI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 LOGANVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-7715
Mailing Address - Country:US
Mailing Address - Phone:770-277-5996
Mailing Address - Fax:
Practice Address - Street 1:1500 OGLETHORPE AVE STE 2500
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2189
Practice Address - Country:US
Practice Address - Phone:706-548-7909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-12
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN291548363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care