Healthcare Provider Details

I. General information

NPI: 1871429902
Provider Name (Legal Business Name): AMBER RENEE IVORY DANIELS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 TURNPIKE AVE
CLEARFIELD PA
16830-1233
US

IV. Provider business mailing address

1148 ELIZABETH ST
COALPORT PA
16627-8829
US

V. Phone/Fax

Practice location:
  • Phone: 814-765-6644
  • Fax:
Mailing address:
  • Phone: 814-592-8124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberSP036192
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: