Provider Demographics
NPI:1083131304
Name:SMITH, DANIELLE JOLENE (CRNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:JOLENE
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:JOLENE
Other - Last Name:SCHAEFFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3783
Mailing Address - Country:US
Mailing Address - Phone:724-689-0520
Mailing Address - Fax:724-689-0522
Practice Address - Street 1:200 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3783
Practice Address - Country:US
Practice Address - Phone:724-689-0520
Practice Address - Fax:724-689-0522
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017833363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily