Provider Demographics
NPI:1679375174
Name:LANDER, DANIELLE NICHELLE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:NICHELLE
Last Name:LANDER
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 1:30 E SIEBENTHALER AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-2424
Mailing Address - Country:US
Mailing Address - Phone:937-554-9019
Mailing Address - Fax:
Practice Address - Street 1:30 E SIEBENTHALER AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-2424
Practice Address - Country:US
Practice Address - Phone:937-554-9019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker