Provider Demographics
NPI:1184329138
Name:NIGHTINGALE, DANNA LYNN (CRPA)
Entity type:Individual
Prefix:
First Name:DANNA
Middle Name:LYNN
Last Name:NIGHTINGALE
Suffix:
Gender:F
Credentials:CRPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ELM ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-1860
Mailing Address - Country:US
Mailing Address - Phone:607-267-4435
Mailing Address - Fax:607-267-4534
Practice Address - Street 1:22 ELM ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-1860
Practice Address - Country:US
Practice Address - Phone:607-267-4435
Practice Address - Fax:607-267-4534
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCE38897SMedicaid