Individual
DR. JONATHAN DAVID DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D. APN FNP-BC
Contact information
Practice address
707 JUDITH DR, JOHNSON CITY, TN 37604-1924
(619) 630-9034
Mailing address
707 JUDITH DR, JOHNSON CITY, TN 37604-1924
(619) 630-9034
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
67511
TN
363LF0000X
Family Nurse Practitioner
1079
AK
363LF0000X
Family Nurse Practitioner
Primary
5967
TN
Other
Enumeration date
06/10/2011
Last updated
06/05/2012
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