Provider Demographics
NPI:1720697949
Name:MCDANIEL, LORNA GAY
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:GAY
Last Name:MCDANIEL
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 1:2457 CHARLESTON RD
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550-3710
Mailing Address - Country:US
Mailing Address - Phone:304-675-0252
Mailing Address - Fax:
Practice Address - Street 1:2457 CHARLESTON RD
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-3710
Practice Address - Country:US
Practice Address - Phone:304-675-0252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant