Provider Demographics
NPI:1275325904
Name:GINGRAS, DANIELLE ANN (LPN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ANN
Last Name:GINGRAS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:ANN
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 347
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:VT
Mailing Address - Zip Code:05679-0347
Mailing Address - Country:US
Mailing Address - Phone:802-279-4101
Mailing Address - Fax:
Practice Address - Street 1:1082 US ROUTE 2
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05676-9057
Practice Address - Country:US
Practice Address - Phone:802-279-4101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT025.0007304164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty