Provider Demographics
NPI:1881155653
Name:LARKIN, DANIELLE
Entity type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:
Last Name:LARKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 RIVEREDGE PKWY STE GL100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5812
Mailing Address - Country:US
Mailing Address - Phone:404-843-6500
Mailing Address - Fax:
Practice Address - Street 1:449 KENSINGTON PARC DR
Practice Address - Street 2:
Practice Address - City:AVONDALE ESTATES
Practice Address - State:GA
Practice Address - Zip Code:30002-1776
Practice Address - Country:US
Practice Address - Phone:773-510-6244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP001020207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty