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General NPI Number Information
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NPI Number | 1700375524
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Entity Type | Individual
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Provider Name | DANIELLE NICOLE FASSIEUX CRNA
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Gender | Female
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 2825 RANDOLPH RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-1018
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Country | US
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Telephone | 704-377-1647
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Fax |
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Provider Business Mailing Address
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Address Line | 12714 WILLINGDON RD
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-5704
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Country | US
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Telephone | 619-248-6030
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 685804
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 328754
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License Number State | NC
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