Healthcare Provider Details

I. General information

NPI: 1841755329
Provider Name (Legal Business Name): DANIELLE LEE GOODELL CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE LEE D'AMATO

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4126 N HOLLAND SYLVANIA RD STE 105
TOLEDO OH
43623-3541
US

IV. Provider business mailing address

4235 SECOR RD
TOLEDO OH
43623-4299
US

V. Phone/Fax

Practice location:
  • Phone: 419-479-5605
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number023909
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.023909
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4704231348
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: