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NPI Code Detail

MEDICARE: MRS. DANIELLE LEE CRNA

MEDICARE: MRS. DANIELLE LEE CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse1-162149AL
2367500000XCertified Registered Nurse Anesthetist1-162149AL

General Provider Information

NPI Number : 1831897271
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DANIELLE LEE CRNA
Provider Business Mailing Address
First Line : 2124 HOME PARK TRL APT 212
Second Line :
City : PRATTVILLE
State : AL
Zip : 36066-7879
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 400 TAYLOR RD
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-3511
Country : US
Telephone Number : 334-277-8330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2023
Last Update Date : 10/20/2024

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