Provider Demographics
NPI:1801089362
Name:DANFORD, ALESIA MARIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:ALESIA
Middle Name:MARIE
Last Name:DANFORD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12141 GEORGETOWN ST NE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:OH
Mailing Address - Zip Code:44669-9704
Mailing Address - Country:US
Mailing Address - Phone:330-862-9009
Mailing Address - Fax:
Practice Address - Street 1:12141 GEORGETOWN ST NE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:OH
Practice Address - Zip Code:44669-9704
Practice Address - Country:US
Practice Address - Phone:330-862-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-19
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH119345164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse