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Individual

TIMOTHY PETER DANIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGACNP

Contact information

Practice address
64A JONES MILL RD, WOODBURY, GA 30293-2678
(706) 553-5367
(705) 553-5370
Mailing address
145 JONES MILL RD, WOODBURY, GA 30293-2772
(770) 712-0729

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN235633
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN235633
GA

Other

Enumeration date
10/20/2018
Last updated
07/26/2019
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