Provider Demographics
NPI:1467650671
Name:DOBBINS, DANIELLE PAVLYN (PA-C, MMS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:PAVLYN
Last Name:DOBBINS
Suffix:
Gender:F
Credentials:PA-C, MMS
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:PAVLYN
Other - Last Name:ZOLLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:785 5TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4218
Practice Address - Street 1:13620 CRAYTON BLVD STE A
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2335
Practice Address - Country:US
Practice Address - Phone:240-313-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC03563363A00000X, 363A00000X
PAMA053904363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
12332687OtherCAQH
PA103160270Medicaid