Healthcare Provider Details

I. General information

NPI: 1841625654
Provider Name (Legal Business Name): DANIELLE AYERS DESTFINO CRNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE AYERS DESTFINO CRNP

II. Dates (important events)

Enumeration Date: 09/11/2013
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 EISENHOWER BLVD
JOHNSTOWN PA
15904-3217
US

IV. Provider business mailing address

1415 EISENHOWER BLVD
JOHNSTOWN PA
15904-3217
US

V. Phone/Fax

Practice location:
  • Phone: 814-270-6812
  • Fax:
Mailing address:
  • Phone: 814-270-6812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR238171
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR238171
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP016305
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: