Provider Demographics
NPI:1548541055
Name:CAMERON, DANYELE D
Entity type:Individual
Prefix:
First Name:DANYELE
Middle Name:D
Last Name:CAMERON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 PROVIDENCE DR
Mailing Address - Street 2:APT. 5
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-8539
Mailing Address - Country:US
Mailing Address - Phone:513-578-7988
Mailing Address - Fax:
Practice Address - Street 1:58 PROVIDENCE DR
Practice Address - Street 2:APT. 5
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-8539
Practice Address - Country:US
Practice Address - Phone:513-578-7988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.142781-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse