Provider Demographics
NPI:1992712327
Name:HARRIS, DANIELLE L (CNS)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:L
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:L
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNS
Mailing Address - Street 1:4686 W 228TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-2423
Mailing Address - Country:US
Mailing Address - Phone:216-835-8323
Mailing Address - Fax:
Practice Address - Street 1:7575 NORTHCLIFF AVE STE 200
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-3268
Practice Address - Country:US
Practice Address - Phone:216-417-3700
Practice Address - Fax:216-675-3700
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN301626364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2675725Medicaid
OHBRNS75531Medicare ID - Type Unspecified
OH2675725Medicaid