Provider Demographics
NPI:1790583797
Name:GUSTIN, DANIELLE BRIANNA
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:BRIANNA
Last Name:GUSTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 ELEMENTARY ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-8646
Mailing Address - Country:US
Mailing Address - Phone:509-619-2984
Mailing Address - Fax:
Practice Address - Street 1:1515 ELEMENTARY ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-8646
Practice Address - Country:US
Practice Address - Phone:509-619-2984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60557502163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool