Provider Demographics
NPI:1205353067
Name:TRAPPER, DARYL LINDSAY (NP)
Entity type:Individual
Prefix:
First Name:DARYL
Middle Name:LINDSAY
Last Name:TRAPPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DARYL
Other - Middle Name:LINDSAY
Other - Last Name:NEDIMYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4225 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1994
Mailing Address - Country:US
Mailing Address - Phone:1716-906-5908
Mailing Address - Fax:
Practice Address - Street 1:5959 BIG TREE RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2291
Practice Address - Country:US
Practice Address - Phone:716-204-3200
Practice Address - Fax:716-204-3200
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF342037-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner