Provider Demographics
NPI:1386457802
Name:LAIDLER, DANIELLE NIKOLE (AG-CNS-BC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:NIKOLE
Last Name:LAIDLER
Suffix:
Gender:F
Credentials:AG-CNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3386 HIDDEN STREAM CT
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6932
Mailing Address - Country:US
Mailing Address - Phone:478-244-1024
Mailing Address - Fax:
Practice Address - Street 1:3386 HIDDEN STREAM CT
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6932
Practice Address - Country:US
Practice Address - Phone:478-244-1024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN231804364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Single Specialty