Provider Demographics
NPI:1902612724
Name:JUSTINIANO, DANIELLE (RN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:JUSTINIANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 BANK ST APT 181
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-1281
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 BANK ST APT 181
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-1281
Practice Address - Country:US
Practice Address - Phone:917-749-7291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25088271163WL0100X, 163WM0102X, 163WP0200X, 163W00000X, 163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience