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General NPI Number Information
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NPI Number | 1750648044
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Entity Type | Individual
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Provider Name | DANIELLE ALEXIS DEINES D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 310 SUNNYVIEW LN
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City | KALISPELL
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State | MT
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Zip | 59901-3129
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Country | US
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Telephone | 406-751-5391
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Fax | 406-751-2988
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Provider Business Mailing Address
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Address Line | 2211 LOMAS BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-2719
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Country | US
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Telephone | 828-712-4555
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 0102205284
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | DO2022-0007
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 103540
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License Number State | MT
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