Healthcare Provider Details

I. General information

NPI: 1437967429
Provider Name (Legal Business Name): DANIELLE JAMIE EVANS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2024
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 MORMAN RD
HAMILTON OH
45013-4456
US

IV. Provider business mailing address

2702 TYLERSVILLE RD LOT 33
FAIRFIELD TOWNSHIP OH
45015-3300
US

V. Phone/Fax

Practice location:
  • Phone: 513-608-4265
  • Fax:
Mailing address:
  • Phone: 513-846-9728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: