Provider Demographics
NPI:1538175989
Name:CURTIS, DANITA (FNP)
Entity type:Individual
Prefix:
First Name:DANITA
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DANITA
Other - Middle Name:
Other - Last Name:BOVEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:99 E STATE ST
Mailing Address - Street 2:PO BOX 1250
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-1203
Mailing Address - Country:US
Mailing Address - Phone:518-762-6731
Mailing Address - Fax:518-762-7135
Practice Address - Street 1:110 DECKER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095-2157
Practice Address - Country:US
Practice Address - Phone:518-762-6731
Practice Address - Fax:518-762-7135
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333361363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02777562Medicaid
NY42534OtherMVP HEALTHPLAN