Provider Demographics
NPI:1043783087
Name:MCNEIL, DANIELLE LAVETTE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LAVETTE
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2107
Mailing Address - Country:US
Mailing Address - Phone:984-219-6013
Mailing Address - Fax:
Practice Address - Street 1:3407 N DUKE ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2107
Practice Address - Country:US
Practice Address - Phone:984-219-6013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC5072251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health