Provider Demographics
NPI:1225307515
Name:STEVERSON, DANIELLE S (STNA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:S
Last Name:STEVERSON
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 EAST BLVD
Mailing Address - Street 2:4
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-4035
Mailing Address - Country:US
Mailing Address - Phone:440-749-7472
Mailing Address - Fax:
Practice Address - Street 1:1377 EAST BLVD
Practice Address - Street 2:4
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-4035
Practice Address - Country:US
Practice Address - Phone:440-749-7472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401183311210376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide