Healthcare Provider Details

I. General information

NPI: 1619688447
Provider Name (Legal Business Name): DANIELLE MARTIN CHARLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2256 RICE ST
CINCINNATI OH
45219-1864
US

IV. Provider business mailing address

2256 RICE ST
CINCINNATI OH
45219-1864
US

V. Phone/Fax

Practice location:
  • Phone: 513-846-4513
  • Fax:
Mailing address:
  • Phone: 513-846-4513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0035945
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.430491
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: