Basic Information
Provider Information | |||||||||
NPI: | 1134318124 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | BIELECKI | ||||||||
FirstName: | DANIELLE | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | MS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | CRNP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 30 MONUMENT RD | ||||||||
Address2: | STE 1100 | ||||||||
City: | YORK | ||||||||
State: | PA | ||||||||
PostalCode: | 174035024 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7178516454 | ||||||||
FaxNumber: | 7178511665 | ||||||||
Practice Location | |||||||||
Address1: | 201 E UNIVERSITY PKWY | ||||||||
Address2: |   | ||||||||
City: | BALTIMORE | ||||||||
State: | MD | ||||||||
PostalCode: | 212182829 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4105542000 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/16/2007 | ||||||||
LastUpdateDate: | 04/23/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 04/23/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | SP009573 | PA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LA2100X | R211931 | MD | N |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
ID | Type | State | Issuer | Description | 2009553 | 01 | PA | HIGHMARK BS FREEDOM BLUE | OTHER | 1572753 | 01 | PA | GATEWAY-WMG | OTHER | 50074377 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 919158-01 | 01 |   | CAREFIRST MD BCBS | OTHER | 210213 | 01 | PA | JOHNS HOPKINS | OTHER |