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NPI Code Detail

MEDICARE: AUDREY PHILLIPS DANIELS C.R.N.P.

MEDICARE: AUDREY PHILLIPS DANIELS C.R.N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerVP004963WPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN235493LOTHERPARN
2VP004963WOTHERPACRNP

General Provider Information

NPI Number : 1346265956
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY PHILLIPS DANIELS C.R.N.P.
Provider Business Mailing Address
First Line : 3015 HUDSON AVE
Second Line :
City : MC DONALD
State : PA
Zip : 15057-2247
Country : US
Telephone Number : 724-926-2866
Fax Number :
Provider Business Practice Location Address
First Line : 712 SOUTH AVE
Second Line :
City : PITTSBURGH
State : PA
Zip : 15221-2940
Country : US
Telephone Number : 412-243-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 03/07/2023

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