Provider Demographics
NPI:1871839142
Name:PICKELL, DANYELLE LAURABELLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DANYELLE
Middle Name:LAURABELLE
Last Name:PICKELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 DEARTH RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45644-9528
Mailing Address - Country:US
Mailing Address - Phone:740-655-2814
Mailing Address - Fax:
Practice Address - Street 1:818 DEARTH RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:OH
Practice Address - Zip Code:45644-9528
Practice Address - Country:US
Practice Address - Phone:470-655-2814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.151623-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse