Provider Demographics
NPI:1396152476
Name:DANIELS, CORDIE (RN)
Entity type:Individual
Prefix:MRS
First Name:CORDIE
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 STONINGTON LN
Mailing Address - Street 2:APT. #3
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1564
Mailing Address - Country:US
Mailing Address - Phone:716-908-0621
Mailing Address - Fax:
Practice Address - Street 1:50 STONINGTON LN
Practice Address - Street 2:APT. #3
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1564
Practice Address - Country:US
Practice Address - Phone:716-908-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5454431163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse