Provider Demographics
NPI:1780408914
Name:DRIVER, DAMIYA LONYA
Entity type:Individual
Prefix:
First Name:DAMIYA
Middle Name:LONYA
Last Name:DRIVER
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 1:8147 CHESTERHILL LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-7939
Mailing Address - Country:US
Mailing Address - Phone:317-777-9681
Mailing Address - Fax:
Practice Address - Street 1:8147 CHESTERHILL LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-7939
Practice Address - Country:US
Practice Address - Phone:317-777-9681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN24-018384-1374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide