Provider Demographics
NPI:1386465490
Name:MCDONALD, DANIELLE WILLIAMS (RN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:WILLIAMS
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2571
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71207-2571
Mailing Address - Country:US
Mailing Address - Phone:318-582-5069
Mailing Address - Fax:318-582-5220
Practice Address - Street 1:1651 LOUISVILLE AVE STE 128
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6040
Practice Address - Country:US
Practice Address - Phone:318-582-5069
Practice Address - Fax:318-582-5220
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN126605163WC0400X, 163WC1500X, 163WX0002X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
Provider Identifiers
StateIdentifier IDID TypeIssuer
LARN126605OtherRN LICENSE LOUISIANA