MEDICARE: MS. DANIELE NICOLE LANIER LPN

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
1	164W00000X	Licensed Practical Nurse	4703089139	MI

General Provider Information

NPI Number	:	1366658155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANIELE NICOLE LANIER LPN

Provider Business Mailing Address
First Line	:	14310 RUTHERFORD ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48227-1834
Country	:	US
Telephone Number	:	313-399-0587
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 N OAKLAND BLVD
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48327-1582
Country	:	US
Telephone Number	:	248-406-0090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	07/08/2007

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