Provider Demographics
NPI:1629331194
Name:DANIELS, SIVI BURNS (BS, LPN)
Entity Type:Individual
Prefix:MS
First Name:SIVI
Middle Name:BURNS
Last Name:DANIELS
Suffix:
Gender:F
Credentials:BS, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 CARTER STREET
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2811
Mailing Address - Country:US
Mailing Address - Phone:803-786-1183
Mailing Address - Fax:
Practice Address - Street 1:1135 CARTER ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2811
Practice Address - Country:US
Practice Address - Phone:803-786-1183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPR38235164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse