Basic Information
Provider Information
NPI: 1427791409
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KENDALL
FirstName: DANIELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6 BUTTRICK RD
Address2: STE 102
City: LONDONDERRY
State: NH
PostalCode: 030533417
CountryCode: US
TelephoneNumber: 6035371300
FaxNumber:  
Practice Location
Address1: 6 TSIENNETO RD STE 100
Address2:  
City: DERRY
State: NH
PostalCode: 030381584
CountryCode: US
TelephoneNumber: 6035371300
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/18/2022
LastUpdateDate: 06/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X078206-23NHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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