Provider Demographics
NPI:1053370296
Name:DANIELS, ROBYN J (CRNP)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:J
Last Name:DANIELS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 9TH AVE
Mailing Address - Street 2:STATION MEDICAL CENTER
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2454
Mailing Address - Country:US
Mailing Address - Phone:814-946-1655
Mailing Address - Fax:814-949-7616
Practice Address - Street 1:620 HOWARD AVE
Practice Address - Street 2:OP-2
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4804
Practice Address - Country:US
Practice Address - Phone:814-889-6980
Practice Address - Fax:814-889-6994
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP006892M363LA2100X
PARN231234L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
P48634Medicare UPIN
PA054212Medicare ID - Type Unspecified