Provider Demographics
NPI:1487148417
Name:DANIELS, SHARONDA ANTOINETTE (CNA)
Entity type:Individual
Prefix:
First Name:SHARONDA
Middle Name:ANTOINETTE
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 1:722 GREENLEAF DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32305-7407
Mailing Address - Country:US
Mailing Address - Phone:850-590-2651
Mailing Address - Fax:
Practice Address - Street 1:722 GREENLEAF DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32305-7407
Practice Address - Country:US
Practice Address - Phone:850-590-2651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL338719376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide