Provider Demographics
NPI:1588265250
Name:DANIELS-ARCHIE, SHARONN CELESTE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHARONN
Middle Name:CELESTE
Last Name:DANIELS-ARCHIE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 W LEHIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-3207
Mailing Address - Country:US
Mailing Address - Phone:267-970-8480
Mailing Address - Fax:
Practice Address - Street 1:1401 S 31ST ST FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-3506
Practice Address - Country:US
Practice Address - Phone:215-925-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-07
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022717363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily