Provider Demographics
NPI:1043507718
Name:BARNETT-TRAPP, DANIELLE L (DO)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:L
Last Name:BARNETT-TRAPP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2927 N 7TH AVE
Mailing Address - Street 2:ST. JOSEPH'S FAMILY MEDICINE- PEPPERTREE BLDG.
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4102
Mailing Address - Country:US
Mailing Address - Phone:602-406-3153
Mailing Address - Fax:602-406-7176
Practice Address - Street 1:19389 N 59TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:236-537-6000
Practice Address - Fax:623-537-6101
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ06114207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR1862OtherTRAINING PERMIT