Provider Demographics
NPI:1649085077
Name:PAUL, DANEEN R (CMA)
Entity type:Individual
Prefix:MISS
First Name:DANEEN
Middle Name:R
Last Name:PAUL
Suffix:
Gender:F
Credentials:CMA
Other - Prefix:MRS
Other - First Name:DANEEN
Other - Middle Name:R
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:304 WALDAN CIR # 304
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-7102
Mailing Address - Country:US
Mailing Address - Phone:646-886-2630
Mailing Address - Fax:
Practice Address - Street 1:304 WALDAN CIR # 304
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-7102
Practice Address - Country:US
Practice Address - Phone:646-886-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA385H00000X, 374U00000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No385H00000XRespite Care FacilityRespite Care
No376J00000XNursing Service Related ProvidersHomemaker