Provider Demographics
NPI:1689869240
Name:LIGGETT, DANI (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DANI
Middle Name:
Last Name:LIGGETT
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 1:1425 PORTER ST
Mailing Address - Street 2:MED DIVISION
Mailing Address - City:FORT DETRICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-9211
Mailing Address - Country:US
Mailing Address - Phone:301-619-6948
Mailing Address - Fax:301-619-2312
Practice Address - Street 1:1425 PORTER ST
Practice Address - Street 2:MED DIVISION
Practice Address - City:FORT DETRICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9211
Practice Address - Country:US
Practice Address - Phone:301-619-6948
Practice Address - Fax:301-619-2312
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP19019164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse