Healthcare Provider Details

I. General information

NPI: 1891106415
Provider Name (Legal Business Name): DANIELLE KASSELLA ARNP, PMHNP-BC FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SE MONTEREY COMMONS BLVD STE 104
STUART FL
34996-3327
US

IV. Provider business mailing address

13780 SE 46TH ST
OKEECHOBEE FL
34974-1014
US

V. Phone/Fax

Practice location:
  • Phone: 772-882-8900
  • Fax:
Mailing address:
  • Phone: 863-634-2672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP2917662
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN2917662
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: