MEDICARE: RHONDA DENISE DANIEL NURSE

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	185104	OH
2	163W00000X	Registered Nurse	543864	OH

General Provider Information

NPI Number	:	1952185506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA DENISE DANIEL NURSE

Provider Business Mailing Address
First Line	:	6712 CHERI LYNNE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-2118
Country	:	US
Telephone Number	:	937-818-6337
Fax Number	:

Provider Business Practice Location Address
First Line	:	6712 CHERI LYNNE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-2118
Country	:	US
Telephone Number	:	937-818-6337
Fax Number	:

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

Provider Enumeration Date	:	08/23/2023
Last Update Date	:	06/04/2025

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