Provider Demographics
NPI:1750190229
Name:CLARKE, DANYEL L
Entity type:Individual
Prefix:
First Name:DANYEL
Middle Name:L
Last Name:CLARKE
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 1:4340 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-2059
Mailing Address - Country:US
Mailing Address - Phone:402-417-9398
Mailing Address - Fax:
Practice Address - Street 1:808 P ST STE 206
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-1383
Practice Address - Country:US
Practice Address - Phone:402-937-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide