Healthcare Provider Details

I. General information

NPI: 1770364002
Provider Name (Legal Business Name): HEATHER KAY DANIEL NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 MAIN ST
ROANOKE AL
36274-2512
US

IV. Provider business mailing address

PO BOX 2345
ANNISTON AL
36202-2345
US

V. Phone/Fax

Practice location:
  • Phone: 334-863-2311
  • Fax: 334-863-5596
Mailing address:
  • Phone: 256-235-5015
  • Fax: 256-231-2841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3-002910
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: