Provider Demographics
NPI:1992416267
Name:BRANZBURG, DANIEL LEE (FNP-C)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:LEE
Last Name:BRANZBURG
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 MUD CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:PA
Mailing Address - Zip Code:16947-9529
Mailing Address - Country:US
Mailing Address - Phone:570-297-3746
Mailing Address - Fax:
Practice Address - Street 1:7 WATER ST
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-1126
Practice Address - Country:US
Practice Address - Phone:570-724-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN654261163WG0000X
PASP026995363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice