Individual
MRS. STEPHANIE BENNETT MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
207209
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
NP207209
GA
364SG0600X
Gerontology Clinical Nurse Specialist
RN207209
GA
Other
Enumeration date
01/26/2015
Last updated
10/13/2025
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