Provider Demographics
NPI:1366214603
Name:LIPNICKEY, DANIELLE CAMPOSA (MSN, APN, AGPCNP-C)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:CAMPOSA
Last Name:LIPNICKEY
Suffix:
Gender:F
Credentials:MSN, APN, AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 SHOTWELL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07832-2810
Mailing Address - Country:US
Mailing Address - Phone:973-945-1180
Mailing Address - Fax:
Practice Address - Street 1:8 SADDLE RD STE 203
Practice Address - Street 2:
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-1902
Practice Address - Country:US
Practice Address - Phone:973-993-5950
Practice Address - Fax:973-993-5953
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14934800363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology