Provider Demographics
NPI:1720523947
Name:SCOTT, DANIELLE (RN, MSN FNP-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RN, MSN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13023 E US HIGHWAY 14
Mailing Address - Street 2:
Mailing Address - City:AVALON
Mailing Address - State:WI
Mailing Address - Zip Code:53505-9571
Mailing Address - Country:US
Mailing Address - Phone:262-203-1050
Mailing Address - Fax:
Practice Address - Street 1:10701 W RESEARCH DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3452
Practice Address - Country:US
Practice Address - Phone:414-443-4814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-23
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7193363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily