Provider Demographics
NPI:1588129563
Name:MUSHINSKY, DANIELLE VACCARO (MSN APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:VACCARO
Last Name:MUSHINSKY
Suffix:
Gender:F
Credentials:MSN APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13630 BALL PARK RD
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-6803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9118 BLUEBONNET CENTRE BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2993
Practice Address - Country:US
Practice Address - Phone:225-368-2300
Practice Address - Fax:225-368-2280
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA203667363LF0000X
LAF01191810363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily