Provider Demographics
NPI:1356876213
Name:DANIELS, RICHELLE L (LPN)
Entity type:Individual
Prefix:
First Name:RICHELLE
Middle Name:L
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 1:26740 JOY RD
Mailing Address - Street 2:D11
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-1970
Mailing Address - Country:US
Mailing Address - Phone:734-799-3906
Mailing Address - Fax:
Practice Address - Street 1:26740 JOY RD
Practice Address - Street 2:D11
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-1970
Practice Address - Country:US
Practice Address - Phone:734-799-3906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703117467372600000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No372600000XNursing Service Related ProvidersAdult Companion