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General NPI Number Information
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NPI Number | 1124610845
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Entity Type | Individual
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Provider Name | DANIELLE CHRISTINE GAUDETTE RN
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Gender | Female
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 3401 CIVIC CENTER BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4319
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Country | US
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Telephone | 215-590-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 600 CHARLES ELLIS DR APT 108
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-1326
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Country | US
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Telephone | 508-614-0070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | SP023787
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN688449
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR21378900
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License Number State | NJ
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