Healthcare Provider Details

I. General information

NPI: 1386927283
Provider Name (Legal Business Name): JAMES G MCDANIEL EDD, ARNP, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAMES GOODLETT MCDANIEL NP

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

V. Phone/Fax

Practice location:
  • Phone: 800-324-8387
  • Fax: 352-374-6113
Mailing address:
  • Phone: 800-324-8387
  • Fax: 352-374-6113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024171348
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number0015000181
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: