Provider Demographics
NPI:1912792573
Name:CARTER, DANIELLE RHAE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RHAE
Last Name:CARTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12985 BURSLEY RD
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OH
Mailing Address - Zip Code:44275-9511
Mailing Address - Country:US
Mailing Address - Phone:330-635-3394
Mailing Address - Fax:
Practice Address - Street 1:12985 BURSLEY RD
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:OH
Practice Address - Zip Code:44275-9511
Practice Address - Country:US
Practice Address - Phone:330-635-3394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 251E00000X, 374U00000X, 385H00000X
OH160988164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No172A00000XOther Service ProvidersDriver
No251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide
No385H00000XRespite Care FacilityRespite Care