Provider Demographics
NPI:1477297786
Name:SHREVE, DANIELLE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:SHREVE
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 1:248 STATE ROUTE 604
Mailing Address - Street 2:
Mailing Address - City:POLK
Mailing Address - State:OH
Mailing Address - Zip Code:44866-9721
Mailing Address - Country:US
Mailing Address - Phone:419-685-5987
Mailing Address - Fax:
Practice Address - Street 1:248 STATE ROUTE 604
Practice Address - Street 2:
Practice Address - City:POLK
Practice Address - State:OH
Practice Address - Zip Code:44866-9721
Practice Address - Country:US
Practice Address - Phone:419-685-5987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health