Provider Demographics
NPI:1780447763
Name:LEWIS, DANYELLA MARIE
Entity type:Individual
Prefix:
First Name:DANYELLA
Middle Name:MARIE
Last Name:LEWIS
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 1:1588 STATE ROUTE 43 LOT 5
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:OH
Mailing Address - Zip Code:43944-6922
Mailing Address - Country:US
Mailing Address - Phone:786-932-2751
Mailing Address - Fax:
Practice Address - Street 1:1588 STATE ROUTE 43 LOT 5
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:OH
Practice Address - Zip Code:43944-6922
Practice Address - Country:US
Practice Address - Phone:786-932-2751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant