Provider Demographics
NPI:1871114264
Name:O'HARA, DANIELLE NICHOLE (MD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:NICHOLE
Last Name:O'HARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 BURNETT-WOMACK BLDG CB #7065
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7065
Mailing Address - Country:US
Mailing Address - Phone:919-966-3381
Mailing Address - Fax:919-966-3475
Practice Address - Street 1:3040 BURNETT-WOMACK BLDG CB #7065
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7065
Practice Address - Country:US
Practice Address - Phone:919-966-3381
Practice Address - Fax:919-966-3475
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261316390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program