Provider Demographics
NPI:1659615615
Name:TITUS, DANIELLE MARIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:MARIE
Last Name:TITUS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:BRODFUEHRER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38448 S STONEHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:DRUMMOND ISLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49726-9616
Mailing Address - Country:US
Mailing Address - Phone:716-525-3030
Mailing Address - Fax:
Practice Address - Street 1:38448 S STONEHOUSE RD
Practice Address - Street 2:
Practice Address - City:DRUMMOND ISLAND
Practice Address - State:MI
Practice Address - Zip Code:49726-9616
Practice Address - Country:US
Practice Address - Phone:716-525-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304280-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse