Healthcare Provider Details

I. General information

NPI: 1548516040
Provider Name (Legal Business Name): DANIELLE M. MCPEAK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 HIGHLAND PARK DR
RICHMOND KY
40475-3839
US

IV. Provider business mailing address

401 HIGHLAND PARK DR
RICHMOND KY
40475-3839
US

V. Phone/Fax

Practice location:
  • Phone: 859-626-7700
  • Fax: 859-626-7890
Mailing address:
  • Phone: 859-626-7700
  • Fax: 859-626-7890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number3007540
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1114949
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3007540
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3007540
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: