Provider Demographics
NPI:1821419805
Name:DANIELS, CLAUDIA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:MARIE
Last Name:DANIELS
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 1:2170 HYDE PARK RD
Mailing Address - Street 2:7140 E.NEVADA
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-4995
Mailing Address - Country:US
Mailing Address - Phone:313-396-5678
Mailing Address - Fax:
Practice Address - Street 1:2170 HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-4995
Practice Address - Country:US
Practice Address - Phone:313-396-5678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704178019163W00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No251S00000XAgenciesCommunity/Behavioral Health