Individual
EMMYLOU K MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 772-3485
(540) 772-3486
Mailing address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 772-3485
(540) 772-3486
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024170044
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
77925
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174881205
—
VA
Enumeration date
04/26/2012
Last updated
11/01/2013
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