Provider Demographics
NPI:1144987470
Name:GLANDING, DANIELLE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:GLANDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 PETERS CORNER RD
Mailing Address - Street 2:
Mailing Address - City:MARYDEL
Mailing Address - State:MD
Mailing Address - Zip Code:21649-1238
Mailing Address - Country:US
Mailing Address - Phone:410-708-3291
Mailing Address - Fax:
Practice Address - Street 1:3210 PETERS CORNER RD
Practice Address - Street 2:
Practice Address - City:MARYDEL
Practice Address - State:MD
Practice Address - Zip Code:21649-1238
Practice Address - Country:US
Practice Address - Phone:410-763-6406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR130654163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD01OtherCARECO