Provider Demographics
NPI:1821783416
Name:DANIEL, MIRLANDA
Entity Type:Individual
Prefix:
First Name:MIRLANDA
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1447 RUSTIC DR APT 13
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-7444
Mailing Address - Country:US
Mailing Address - Phone:732-268-9608
Mailing Address - Fax:
Practice Address - Street 1:1447 RUSTIC DR APT 13
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-7444
Practice Address - Country:US
Practice Address - Phone:732-268-9608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula