Provider Demographics
NPI:1689090144
Name:DANIELS, KAREN (LPN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DANIELS
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 1:7391 CADLE AVE
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5708
Mailing Address - Country:US
Mailing Address - Phone:440-975-6010
Mailing Address - Fax:
Practice Address - Street 1:7757 AUBURN RD
Practice Address - Street 2:SUITE 6
Practice Address - City:CONCORD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44077-9609
Practice Address - Country:US
Practice Address - Phone:440-350-2547
Practice Address - Fax:440-350-1997
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 054877-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse