Provider Demographics
NPI:1558057877
Name:WHEELER, DANICA
Entity type:Individual
Prefix:
First Name:DANICA
Middle Name:
Last Name:WHEELER
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 1:3428 W 88TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-4824
Mailing Address - Country:US
Mailing Address - Phone:440-381-6960
Mailing Address - Fax:
Practice Address - Street 1:3428 W 88TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-4824
Practice Address - Country:US
Practice Address - Phone:440-381-6960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2024-12-10
Deactivation Date:2024-11-20
Deactivation Code:
Reactivation Date:2024-12-10
Provider Licenses
StateLicense IDTaxonomies
372500000X, 172A00000X, 343900000X, 372600000X, 3747P1801X, 376J00000X
OHRK468650347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No372500000XNursing Service Related ProvidersChore Provider
No172A00000XOther Service ProvidersDriver
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker