Provider Demographics
NPI:1326891623
Name:ANTHONY, DAYLON JAMAAR
Entity Type:Individual
Prefix:
First Name:DAYLON
Middle Name:JAMAAR
Last Name:ANTHONY
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 1:58608 BELLEVIEW RD STE B
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-3915
Mailing Address - Country:US
Mailing Address - Phone:225-230-2036
Mailing Address - Fax:225-612-9595
Practice Address - Street 1:58608 BELLEVIEW RD STE B
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-3915
Practice Address - Country:US
Practice Address - Phone:225-230-2036
Practice Address - Fax:225-612-9595
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant