Individual
BRENDA JEAN DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1200 STATELINE RD W STE 7, SOUTHAVEN, MS 38671-1430
(662) 342-7676
(662) 342-7675
Mailing address
8760 OAKCHASE CV, WALLS, MS 38680-9400
(662) 404-6454
(662) 342-7676
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
RN0000066174
TN
3747P1801X
Personal Care Attendant
Primary
RN0000066174
TN
Other
Enumeration date
08/06/2010
Last updated
08/06/2010
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