Provider Demographics
NPI:1467722009
Name:LEMMON, DANIEL PAUL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:LEMMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12384 S ABBOTT DOWNING WAY
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5693
Mailing Address - Country:US
Mailing Address - Phone:208-713-3762
Mailing Address - Fax:208-247-4312
Practice Address - Street 1:847 PARKCENTRE WAY STE 4
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-1794
Practice Address - Country:US
Practice Address - Phone:208-713-3762
Practice Address - Fax:208-247-4312
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator