Provider Demographics
NPI:1225150519
Name:DANIELS, YVETTE DENISE (RN)
Entity Type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:DENISE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:YVETTE
Other - Middle Name:DENISE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4142 WINDMILL CIR
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4441
Mailing Address - Country:US
Mailing Address - Phone:410-605-7626
Mailing Address - Fax:410-605-7676
Practice Address - Street 1:3900 LOCH RAVEN BLVD
Practice Address - Street 2:BUILDING #2
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2108
Practice Address - Country:US
Practice Address - Phone:410-605-7626
Practice Address - Fax:410-605-7676
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR107612163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health