Provider Demographics
NPI:1952951873
Name:SWISSHELM, DANIELLE LEIGH (PA-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LEIGH
Last Name:SWISSHELM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:LEIGH
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:888 DAYTON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:YELLOW SPGS
Mailing Address - State:OH
Mailing Address - Zip Code:45387-1777
Mailing Address - Country:US
Mailing Address - Phone:937-767-7291
Mailing Address - Fax:937-767-1302
Practice Address - Street 1:888 DAYTON ST UNIT 106
Practice Address - Street 2:
Practice Address - City:YELLOW SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:45387-1778
Practice Address - Country:US
Practice Address - Phone:937-760-8762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006160RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant