Provider Demographics
NPI:1417354341
Name:MCDONALD, TWANA L (LPN)
Entity Type:Individual
Prefix:
First Name:TWANA
Middle Name:L
Last Name:MCDONALD
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 1:21301 SLOAN DR APT 101
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-2434
Mailing Address - Country:US
Mailing Address - Phone:313-768-4415
Mailing Address - Fax:
Practice Address - Street 1:21301 SLOAN DR APT 101
Practice Address - Street 2:
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225-2434
Practice Address - Country:US
Practice Address - Phone:313-768-4415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703113155164X00000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse