Healthcare Provider Details

I. General information

NPI: 1447719141
Provider Name (Legal Business Name): KATHERINE MCDANIEL CNM, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 03/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4003 MARINER BLVD
SPRING HILL FL
34609-2466
US

IV. Provider business mailing address

9504 PATRICIAN DR
NEW PORT RICHEY FL
34655-5727
US

V. Phone/Fax

Practice location:
  • Phone: 352-263-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11001645
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: