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NPI Code Detail

MEDICARE: DANIELLE GENTIA FUQUA

MEDICARE:   DANIELLE GENTIA FUQUA
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
1247200000XOther Technician
2374U00000XHome Health Aide
33747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1609353671
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE GENTIA FUQUA
Provider Business Mailing Address
First Line : 1721 MINION AVE APT 2
Second Line :
City : CINCINNATI
State : OH
Zip : 45205-1058
Country : US
Telephone Number : 513-252-5715
Fax Number :
Provider Business Practice Location Address
First Line : 1721 MINION AVE APT 2
Second Line :
City : CINCINNATI
State : OH
Zip : 45205-1058
Country : US
Telephone Number : 513-252-5715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2018
Last Update Date : 07/23/2018

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Directions to “ DANIELLE GENTIA FUQUA ” Practice Location

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