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General NPI Number Information
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NPI Number | 1235393117
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Entity Type | Individual
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Provider Name | DANIELLE JACINDA ABRAHAMSON PA
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Gender | Female
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 100 HOSPITAL AVE
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City | DU BOIS
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State | PA
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Zip | 15801-1440
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Country | US
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Telephone | 814-375-3800
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Fax | 814-375-3886
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Provider Business Mailing Address
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Address Line | PO BOX 447 100 HOSPITAL AVE.
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City | DU BOIS
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State | PA
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Zip | 15801-0447
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Country | US
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Telephone | 814-375-3800
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Fax | 814-375-3886
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA053447
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License Number State | PA
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