Provider Demographics
NPI:1275068652
Name:TILTON, DANIELLE (CNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:TILTON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:LJUBI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:531 FIFTH AVE
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024
Mailing Address - Country:US
Mailing Address - Phone:440-285-2300
Mailing Address - Fax:440-285-2320
Practice Address - Street 1:531 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024
Practice Address - Country:US
Practice Address - Phone:440-285-2300
Practice Address - Fax:440-285-2320
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.019704363L00000X, 363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology