Individual
MRS. SANDRA D DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.N.P.
Contact information
Practice address
72 SOUTH BROAD, ELLAVILLE, GA 31806
(229) 937-5321
(229) 937-2232
Mailing address
72 SOUTH BROAD, ELLAVILLE, GA 31806
(229) 937-5321
(229) 937-2232
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN042208
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000019F
—
GA
Enumeration date
02/12/2007
Last updated
07/08/2007
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