Provider Demographics
NPI:1225144603
Name:DANIELS, TONIA M (C-FNP)
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:M
Last Name:DANIELS
Suffix:
Gender:F
Credentials:C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 HARRIS CT
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-8153
Mailing Address - Country:US
Mailing Address - Phone:304-860-6918
Mailing Address - Fax:
Practice Address - Street 1:607 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1205
Practice Address - Country:US
Practice Address - Phone:304-766-9136
Practice Address - Fax:304-766-9139
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN49375363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV7104130000Medicaid
WVP59412Medicare UPIN
WVDANP10407Medicare ID - Type Unspecified