Provider Demographics
NPI:1558934604
Name:CONDON, DANIELLE (CRNA)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:CONDON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:VAN ERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:40 JESSICA DR
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-3570
Mailing Address - Country:US
Mailing Address - Phone:603-769-1141
Mailing Address - Fax:
Practice Address - Street 1:243 CHARLES ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3096
Practice Address - Country:US
Practice Address - Phone:617-523-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2280317367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered