Provider Demographics
NPI:1376013862
Name:DANIEL, ROSE ANN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:ANN
Last Name:DANIEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 S HAWKINS AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7424
Mailing Address - Country:US
Mailing Address - Phone:330-926-6891
Mailing Address - Fax:
Practice Address - Street 1:665 GARRY RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-1760
Practice Address - Country:US
Practice Address - Phone:330-761-7911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.156273.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse