Healthcare Provider Details

I. General information

NPI: 1205556115
Provider Name (Legal Business Name): DANIELLE BERNADETTE ELDER NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 01/27/2024
Certification Date: 01/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CHILDRENS LN
NORFOLK VA
23507-1910
US

IV. Provider business mailing address

109 HOWE ST
NORFOLK VA
23503-4831
US

V. Phone/Fax

Practice location:
  • Phone: 757-416-8776
  • Fax:
Mailing address:
  • Phone: 757-416-8776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number0024185001
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: