Provider Demographics
NPI:1790047405
Name:DANIEL, HATINA SHONTI (RN)
Entity Type:Individual
Prefix:MRS
First Name:HATINA
Middle Name:SHONTI
Last Name:DANIEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14317 WESTROPP AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-1828
Mailing Address - Country:US
Mailing Address - Phone:216-849-8567
Mailing Address - Fax:216-486-6870
Practice Address - Street 1:14317 WESTROPP AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-1828
Practice Address - Country:US
Practice Address - Phone:216-849-8567
Practice Address - Fax:216-486-6870
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-10
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN380302163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse