Provider Demographics
NPI:1083914600
Name:PHILLIPS, DANIEL WILLIAM (MA, MSN, RN, CPNP)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:WILLIAM
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:MA, MSN, RN, CPNP
Other - Prefix:
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Mailing Address - Street 1:1 PERKINS SQ
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1063
Mailing Address - Country:US
Mailing Address - Phone:330-543-3343
Mailing Address - Fax:330-543-3539
Practice Address - Street 1:1 PERKINS SQ
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1063
Practice Address - Country:US
Practice Address - Phone:330-543-3343
Practice Address - Fax:330-543-3539
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHCOA.11570-NP363L00000X, 363L00000X
OHRX.11570-EX1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner