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NPI Code Detail

MEDICARE: SHELLEY DANIELS RN

MEDICARE: SHELLEY DANIELS RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WA0400XAddiction (Substance Use Disorder) Registered NurseRN.256558OH

General Provider Information

NPI Number : 1821663188
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY DANIELS RN
Provider Business Mailing Address
First Line : 2727 SAINT JOHNS RD STE D
Second Line :
City : LIMA
State : OH
Zip : 45804-4029
Country : US
Telephone Number : 567-940-9145
Fax Number : 567-940-9803
Provider Business Practice Location Address
First Line : 2727 SAINT JOHNS RD STE D
Second Line :
City : LIMA
State : OH
Zip : 45804-4029
Country : US
Telephone Number : 567-940-9145
Fax Number : 567-940-9083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2021
Last Update Date : 05/20/2021

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