Provider Demographics
NPI:1043853294
Name:CLEVELAND, DANIELLA ROCHELLE (FNP)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:ROCHELLE
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:DANIELLA
Other - Middle Name:
Other - Last Name:CLEVELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ECK
Mailing Address - Street 1:384 E MARCH ST
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-5723
Mailing Address - Country:US
Mailing Address - Phone:480-628-7930
Mailing Address - Fax:
Practice Address - Street 1:37000 N GANTZEL RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85140-7303
Practice Address - Country:US
Practice Address - Phone:480-394-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ236346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily