Individual
DANIELLE MARIE MENICHELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
300 KEYSTONE AVE, PITTSTON, PA 18640-6153
(833) 552-1852
(570) 214-1525
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4093
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
VP003763B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME92876
BLUE SHIELD
—
Enumeration date
10/06/2006
Last updated
08/11/2020
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