Provider Demographics
NPI:1588005094
Name:MASON, DANIELLE (CNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 WASHINGTON STREET, 14TH FLOOR
Mailing Address - Street 2:EIGHT TOWER BRIDGE, SUITE 14000
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428
Mailing Address - Country:US
Mailing Address - Phone:866-825-3227
Mailing Address - Fax:
Practice Address - Street 1:9775 COLERAIN AVENUE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251
Practice Address - Country:US
Practice Address - Phone:866-825-3227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.14687-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily