Healthcare Provider Details

I. General information

NPI: 1134057912
Provider Name (Legal Business Name): DANIELLE WOLFREY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE COYLE NP

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 LUXOR CT
BUNKER HILL WV
25413-1162
US

IV. Provider business mailing address

39 LUXOR CT
BUNKER HILL WV
25413-1162
US

V. Phone/Fax

Practice location:
  • Phone: 540-514-0940
  • Fax:
Mailing address:
  • Phone: 540-514-0940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number121089
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: