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Individual
WANDA MCDANIEL
Active
Individual
WANDA MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN038289NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000821356A
—
GA
01
—
10033124
AMERIGROUP
GA
01
—
1153620002
PEACHSTATE
GA
01
—
319962
WELLCARE
GA
Enumeration date
08/30/2006
Last updated
11/06/2013
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