Individual
DANIELLE JO MATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, AGACNP-BC
Contact information
Practice address
800 W MEETING ST, LANCASTER, SC 29720-2202
(803) 286-1214
Mailing address
PO BOX 23321, NEW YORK, NY 10087-4321
(803) 286-1214
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
1073627
TX
363L00000X
Nurse Practitioner
Primary
31925
SC
363LA2100X
Acute Care Nurse Practitioner
1073627
TX
363LA2200X
Adult Health Nurse Practitioner
1073627
TX
Other
Enumeration date
12/07/2018
Last updated
05/15/2026
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