Provider Demographics
NPI:1093487886
Name:DANIELS, KAREN MICHELLE
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MICHELLE
Last Name:DANIELS
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 1:22705 LAKE SHORE BLVD APT 225B
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1345
Mailing Address - Country:US
Mailing Address - Phone:216-971-0296
Mailing Address - Fax:
Practice Address - Street 1:22705 LAKE SHORE BLVD APT 225B
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-1345
Practice Address - Country:US
Practice Address - Phone:216-971-0296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide