Provider Demographics
NPI:1104570480
Name:DANIELS, EUCHICA SHINEA (CNA)
Entity type:Individual
Prefix:MS
First Name:EUCHICA
Middle Name:SHINEA
Last Name:DANIELS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8171 JOFFRE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-2416
Mailing Address - Country:US
Mailing Address - Phone:904-438-9626
Mailing Address - Fax:
Practice Address - Street 1:8171 JOFFRE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-2416
Practice Address - Country:US
Practice Address - Phone:904-438-9626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL22000003971390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program