Most Relevant Information
Provider Data
| NPI Number: | 1003478686 |
| Provider Name: | DANIELLE LEE MALLORY APRN FNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 8280 |
Most Important Dates
| Enumeration Date: | 07/03/2019 |
| Last Updated: | 09/08/2021 |
Provider Practice Location
620 NORWICH NEW LONDON TPKE
UNCASVILLE
CT
063822121
Practice Location Phone/Fax
| Phone: | 8608928012 |
| Fax: |
Provider Mailing Location
141 WAY RD
SALEM
CT
064203716
Provider Mailing Phone/Fax
| Phone: | 8609494182 |
| Fax: |