Healthcare Provider Details

I. General information

NPI: 1225959356
Provider Name (Legal Business Name): DANIEL B EDGAR FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 HAND AVE
BAY MINETTE AL
36507-4112
US

IV. Provider business mailing address

PO BOX 202
SILVERHILL AL
36576-0202
US

V. Phone/Fax

Practice location:
  • Phone: 251-937-7970
  • Fax: 251-937-9260
Mailing address:
  • Phone: 251-937-7970
  • Fax: 251-937-7970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-107295
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: