Provider Demographics
NPI:1710271572
Name:CALHOUN, EBONY DANIELLE (LPN)
Entity Type:Individual
Prefix:
First Name:EBONY
Middle Name:DANIELLE
Last Name:CALHOUN
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 1:1806 THERESA CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-6523
Mailing Address - Country:US
Mailing Address - Phone:513-435-5589
Mailing Address - Fax:
Practice Address - Street 1:1806 THERESA CT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-6523
Practice Address - Country:US
Practice Address - Phone:513-435-5589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN124887164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse