Provider Demographics
NPI:1982212577
Name:DANIELS, LAQUITTA MARCELLE (LPN)
Entity Type:Individual
Prefix:
First Name:LAQUITTA
Middle Name:MARCELLE
Last Name:DANIELS
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 1:446 RICHMOND PARK E APT 322
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1857
Mailing Address - Country:US
Mailing Address - Phone:216-609-2448
Mailing Address - Fax:
Practice Address - Street 1:446 RICHMOND PARK E APT 322
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1857
Practice Address - Country:US
Practice Address - Phone:216-609-2448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.151203.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse