Basic Information
| Provider Information | |||||||||
| NPI: | 1811133960 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DANIELS | ||||||||
| FirstName: | PAIGE | ||||||||
| MiddleName: | ALLISON | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3815 E BELL RD | ||||||||
| Address2: | SUITE 2300 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850322122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239352731 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13555 W MCDOWELL RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | GOODYEAR | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853952624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239354700 | ||||||||
| FaxNumber: | 9239354707 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2008 | ||||||||
| LastUpdateDate: | 12/19/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 3079 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA10003224025211 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.