Provider Demographics
NPI:1356415558
Name:GRATE, DANIELLE A (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:A
Last Name:GRATE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MOUNTAIN ST STE 230
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3867
Mailing Address - Country:US
Mailing Address - Phone:775-882-1324
Mailing Address - Fax:775-882-3859
Practice Address - Street 1:1200 MOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3821
Practice Address - Country:US
Practice Address - Phone:775-882-1324
Practice Address - Fax:775-882-3859
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA938363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical