Provider Demographics
NPI:1912874017
Name:WILKINSON-BALLARD, DANAISHA LOVE
Entity type:Individual
Prefix:
First Name:DANAISHA
Middle Name:LOVE
Last Name:WILKINSON-BALLARD
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 1:4711 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-2640
Mailing Address - Country:US
Mailing Address - Phone:402-800-9473
Mailing Address - Fax:
Practice Address - Street 1:4711 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-2640
Practice Address - Country:US
Practice Address - Phone:402-800-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion