=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437380664
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANICA JUNE-MCKEE HEWITT LPN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2009
-----------------------------------------------------
Last Update Date | 08/05/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15898 PINEWOOD TRL
-----------------------------------------------------
City | NEWARK
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43055-8102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-763-4925
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15898 PINEWOOD TRL
-----------------------------------------------------
City | NEWARK
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43055-8102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-763-4925
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164W00000X
-----------------------------------------------------
Taxonomy Name | Licensed Practical Nurse
-----------------------------------------------------
License Number | PN 128113 IV
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------