Provider Demographics
NPI:1699989871
Name:WELL, DANIELLE RACHEL (RN, CRNP)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:RACHEL
Last Name:WELL
Suffix:
Gender:F
Credentials:RN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2831
Mailing Address - Country:US
Mailing Address - Phone:516-569-1393
Mailing Address - Fax:
Practice Address - Street 1:2000 N VILLAGE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1078
Practice Address - Country:US
Practice Address - Phone:516-763-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007301363LF0000X
NY335473363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily