Provider Demographics
NPI:1912551102
Name:DANSON, NICOLE SHARRON
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:SHARRON
Last Name:DANSON
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 1:4101 21ST PL
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-4303
Mailing Address - Country:US
Mailing Address - Phone:240-515-4608
Mailing Address - Fax:
Practice Address - Street 1:4101 21ST PL
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-4303
Practice Address - Country:US
Practice Address - Phone:240-515-4608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant