=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871021444
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIELLE MARKEETA SALES DNP, APRN, WHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2017
-----------------------------------------------------
Last Update Date | 03/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 224 W D.L. INGRAM AVENUE BLDG. 1408
-----------------------------------------------------
City | CANNON AFB
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-904-3917
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 224 W D.L. INGRAM AVE. BLDG. 1408
-----------------------------------------------------
City | CANNON AFB
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-904-3917
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | LH-0000221
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------