Healthcare Provider Details

I. General information

NPI: 1598001869
Provider Name (Legal Business Name): DANIELLE HATTIE SUTTON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE HATTIE MCCAIN CRNP

II. Dates (important events)

Enumeration Date: 12/14/2012
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5999 HARPERS FARM RD STE W250
COLUMBIA MD
21044-3017
US

IV. Provider business mailing address

1589 SULPHUR SPRING RD STE 109
BALTIMORE MD
21227-2542
US

V. Phone/Fax

Practice location:
  • Phone: 410-772-8822
  • Fax: 410-772-9274
Mailing address:
  • Phone: 410-536-5400
  • Fax: 410-737-2168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR174658
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: