Healthcare Provider Details

I. General information

NPI: 1821937210
Provider Name (Legal Business Name): SCHQUWANNA L DANIELS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2443 MADRID DR S
AUGUSTA GA
30906-4080
US

IV. Provider business mailing address

914 BEMAN ST
AUGUSTA GA
30904-3813
US

V. Phone/Fax

Practice location:
  • Phone: 706-414-9863
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number621511
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: