Healthcare Provider Details

I. General information

NPI: 1699144642
Provider Name (Legal Business Name): DANIELLE KATHRYN MALATEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 CORPORATE DR # 4165
JOHNSTON IA
50131-1659
US

IV. Provider business mailing address

601 NORTHWOOD RD STE B
LEXINGTON SC
29072-2118
US

V. Phone/Fax

Practice location:
  • Phone: 319-305-3737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number2178939
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number22461
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG186137
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number22461
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: