Basic Information
Provider Information
NPI: 1891209060
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIPRE
FirstName: DANIELLE
MiddleName: LEA
NamePrefix: DR.
NameSuffix:  
Credential: PHMNP-BC DNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1509 COLLINS RD
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152211252
CountryCode: US
TelephoneNumber: 7244221574
FaxNumber:  
Practice Location
Address1: 1307 FEDERAL ST STE 301
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152124769
CountryCode: US
TelephoneNumber: 4124422335
FaxNumber: 4123304366
Other Information
ProviderEnumerationDate: 11/27/2017
LastUpdateDate: 03/14/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808XSP018151PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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