Vandeberg, Danielle M
Vandeberg, Danielle M is an individual health care provider with primary practice located at 2845 Greenbrier Rd , Green Bay WI 54311-6519. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Student, Health Care / Student in an Organized Health Care Education/Training Program. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Vandeberg, Danielle M can be contacted via phone (414) 525-2400.Contact Information
Primary practice address
2845 Greenbrier Rd
Green Bay WI 54311-6519
Phone: (414) 525-2400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 10958 | Minnesota |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 014695 | Minnesota |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1570 | Minnesota |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 3298 | Wisconsin |
Profile Details
| NPI number | 1386936201 |
|---|---|
| LBN Legal business name | Vandeberg, Danielle M |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 11th, 2011 |
| Last updated | Nov 7th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386936201 | NPPES |
| Minnesota | Other | PO1053637 | MEDICARE RAILROAD |
| Minnesota | MEDICAID | 100038810 | MEDICARE RAILROAD |
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