Individual
MR. JOHN C DANIELS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 450-4785
Mailing address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(301) 256-7157
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001203310
VA
163W00000X
Registered Nurse
265769
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
78444
NC
Other
Enumeration date
11/29/2006
Last updated
06/06/2025
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