Provider Demographics
NPI:1821874249
Name:WALTERS, DANEA KAYUNA (N/A)
Entity Type:Individual
Prefix:
First Name:DANEA
Middle Name:KAYUNA
Last Name:WALTERS
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:DANEA
Other - Middle Name:K
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DANEA WALTERS
Mailing Address - Street 1:7073 KENNARD RD
Mailing Address - Street 2:
Mailing Address - City:SEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44273-8822
Mailing Address - Country:US
Mailing Address - Phone:330-474-9483
Mailing Address - Fax:
Practice Address - Street 1:7073 KENNARD RD
Practice Address - Street 2:
Practice Address - City:SEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44273-8822
Practice Address - Country:US
Practice Address - Phone:330-474-9483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver