Provider Demographics
NPI:1760022107
Name:MORIARITY, DANIELLE (FNP-C, MSN, BSN, RN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MORIARITY
Suffix:
Gender:F
Credentials:FNP-C, MSN, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 IRONGATE CTR STE 2
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3473
Mailing Address - Country:US
Mailing Address - Phone:518-793-4409
Mailing Address - Fax:
Practice Address - Street 1:3 IRONGATE CTR STE 2
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3473
Practice Address - Country:US
Practice Address - Phone:518-793-4409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345368363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily