Healthcare Provider Details
I. General information
NPI: 1043877947
Provider Name (Legal Business Name): DANIELLE STREET RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/26/2019
Last Update Date: 05/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1010 AUDACE AVE APT 209
BOYNTON BEACH FL
33426-3440
US
IV. Provider business mailing address
1010 AUDACE AVE APT 209
BOYNTON BEACH FL
33426-3440
US
V. Phone/Fax
- Phone: 561-308-1998
- Fax:
- Phone: 561-308-1998
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC0400X |
| Taxonomy | Case Management Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1500X |
| Taxonomy | Community Health Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1600X |
| Taxonomy | Continuing Education/Staff Development Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0000X |
| Taxonomy | General Practice Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0600X |
| Taxonomy | Gerontology Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH0500X |
| Taxonomy | Hemodialysis Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WI0500X |
| Taxonomy | Infusion Therapy Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WM0705X |
| Taxonomy | Medical-Surgical Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WM1400X |
| Taxonomy | Nurse Massage Therapist (NMT) |
| License Number | RN9491719 |
| License Number State | FL |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WS0121X |
| Taxonomy | Plastic Surgery Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WW0000X |
| Taxonomy | Wound Care Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WX1500X |
| Taxonomy | Ostomy Care Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
| # 13 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WH0200X |
| Taxonomy | Home Health Registered Nurse |
| License Number | RN9491719 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
