Provider Demographics
NPI:1528431780
Name:OLEJNICZAK, DANIELLE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:OLEJNICZAK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21378 JOHN DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-6405
Mailing Address - Country:US
Mailing Address - Phone:586-764-3878
Mailing Address - Fax:
Practice Address - Street 1:32000 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-2442
Practice Address - Country:US
Practice Address - Phone:248-647-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-09
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704266291367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered