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NPI Code Detail

MEDICARE: FARIDA BALOCH DANIELS FNP-C

MEDICARE: FARIDA BALOCH DANIELS FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN220457GA

General Provider Information

NPI Number : 1912533316
Entity Type Code : Individual
Provider Name (Legal Business Name) : FARIDA BALOCH DANIELS FNP-C
Provider Business Mailing Address
First Line : PO BOX 742616
Second Line :
City : ATLANTA
State : GA
Zip : 30374-2616
Country : US
Telephone Number : 770-219-8420
Fax Number :
Provider Business Practice Location Address
First Line : 12 7TH ST
Second Line :
City : AUBURN
State : GA
Zip : 30011-3202
Country : US
Telephone Number : 770-848-9320
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2020
Last Update Date : 05/31/2023

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Directions to “ FARIDA BALOCH DANIELS FNP-C” Practice Location

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