Provider Demographics
NPI:1609837004
Name:SAXE, DANELLE JOY (PA-C)
Entity Type:Individual
Prefix:
First Name:DANELLE
Middle Name:JOY
Last Name:SAXE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DANELLE
Other - Middle Name:JOY
Other - Last Name:NEEPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:151 JOHN BRADY DR
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756-8401
Practice Address - Country:US
Practice Address - Phone:570-935-0468
Practice Address - Fax:570-935-0479
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA000834363A00000X
PAMA051187363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1031589240001Medicaid
PA285156F6KMedicare PIN