Healthcare Provider Details

I. General information

NPI: 1801560727
Provider Name (Legal Business Name): DANIEL ROBERTS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4235 SECOR RD
TOLEDO OH
43623-4299
US

IV. Provider business mailing address

4235 SECOR RD
TOLEDO OH
43623-4299
US

V. Phone/Fax

Practice location:
  • Phone: 419-479-5418
  • Fax: 419-479-5420
Mailing address:
  • Phone: 419-214-4214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0028047
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: