Provider Demographics
NPI:1033729181
Name:ENIMPAH, DANIEL BERNARD (LPN)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:BERNARD
Last Name:ENIMPAH
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-2518
Mailing Address - Country:US
Mailing Address - Phone:717-769-5841
Mailing Address - Fax:717-273-8244
Practice Address - Street 1:3030 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-2518
Practice Address - Country:US
Practice Address - Phone:717-769-5841
Practice Address - Fax:717-273-8244
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN308312164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse