Provider Demographics
NPI:1528932126
Name:DANIELS, TAVARUS DION (RN)
Entity type:Individual
Prefix:
First Name:TAVARUS
Middle Name:DION
Last Name:DANIELS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 SNAPPING CT
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-8390
Mailing Address - Country:US
Mailing Address - Phone:678-230-0542
Mailing Address - Fax:
Practice Address - Street 1:1702 SNAPPING CT
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-8390
Practice Address - Country:US
Practice Address - Phone:678-230-0542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN254743163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse