Provider Demographics
NPI:1689451361
Name:CHARLES, DAPHNE
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:
Last Name:CHARLES
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:HIGHWAY #2, KM. 80.4, BARRIO SAN DANIEL, SECTOR LAS CAN
Mailing Address - Street 2:PO BOX 4050
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-4050
Mailing Address - Country:US
Mailing Address - Phone:787-878-5475
Mailing Address - Fax:
Practice Address - Street 1:HIGHWAY #2, KM. 80.4, BARRIO SAN DANIEL, SECTOR LAS CAN
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00614-4050
Practice Address - Country:US
Practice Address - Phone:787-878-5475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX817937163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse