Provider Demographics
NPI:1487350583
Name:MANN, DANIELLE CARTER
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CARTER
Last Name:MANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 MOSS ST UNIT 93313
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70509-5129
Mailing Address - Country:US
Mailing Address - Phone:337-274-7259
Mailing Address - Fax:
Practice Address - Street 1:123 OSWALD ST
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-5044
Practice Address - Country:US
Practice Address - Phone:337-274-7259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347B00000XTransportation ServicesBus