Healthcare Provider Details

I. General information

NPI: 1386465490
Provider Name (Legal Business Name): DANIELLE WILLIAMS MCDONALD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 LOUISVILLE AVE STE 128
MONROE LA
71201-6040
US

IV. Provider business mailing address

PO BOX 2571
MONROE LA
71207-2571
US

V. Phone/Fax

Practice location:
  • Phone: 318-582-5069
  • Fax: 318-582-5220
Mailing address:
  • Phone: 318-582-5069
  • Fax: 318-582-5220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN126605
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN126605
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License NumberRN126605
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN126605
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: