Danielle St. George

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

820857 Issued in NY

Practice address

34 Coventry Ave
Mastic, NY 11950-5002

Phone

(631) 772-4977

NPI assigned

Jun 14, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1073007902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 COVENTRY AVE",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119505002",
            "telephone_number": "631-772-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 COVENTRY AVE",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119505002",
            "telephone_number": "631-772-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. GEORGE",
        "first_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "292448",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "820857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nyeshia Skipwith
• Jeanmarie Smith, RN
• Lucille Anne Soderlund, LPN
• Charles Soper
• Soulution Wellness Inc.
• SVC of Mastic LLC
• Michelle Lynn Tighe, LCSW
• Denise Toro
• Robin Torres, LMSW, CASAC-T
• Claire Toussaint

• Registered Nurse in Mastic, NY
• Providers in Mastic, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.