Provider Demographics
NPI:1821525973
Name:LEFEVRE, DANIELLE RENAE (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:RENAE
Last Name:LEFEVRE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13151 SCHAVEY RD
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-9016
Mailing Address - Country:US
Mailing Address - Phone:989-415-7121
Mailing Address - Fax:
Practice Address - Street 1:13151 SCHAVEY RD
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-9016
Practice Address - Country:US
Practice Address - Phone:517-669-2945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005046152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist