DANIELLE NICOLE SHATTUCK NPI 1407534985

NPI Information

  • NPI: 1407534985
  • Provider Name: DANIELLE NICOLE SHATTUCK
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 260 E MIDDLE COUNTRY RD STE 208
    SMITHTOWN, NY
    ZIP 11787
  • Phone: (631) 863-3223

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NPI Details

Danielle Nicole Shattuck is an adult health nurse practitioner in Smithtown, NY with 3 years of experience. Danielle Nicole Shattuck NPI is 1407534985. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduation Year:2023

The provider's business location address is:

260 E MIDDLE COUNTRY RD STE 208
SMITHTOWN, NY
ZIP 11787-925
Phone: (631) 863-3223

The NPI 1407534985 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/6/2023 and was last updated on 10/3/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthF311302-01NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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