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NPI Code Detail

MEDICARE: AMIE RENEE DANIELS PA

MEDICARE: AMIE RENEE DANIELS PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant004244GA

General Provider Information

NPI Number : 1043260383
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMIE RENEE DANIELS PA
Provider Business Mailing Address
First Line : 104 TRADERS PASS
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31088-2206
Country : US
Telephone Number : 478-953-6734
Fax Number : 478-953-6734
Provider Business Practice Location Address
First Line : 2054 WATSON BLVD
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31093-3634
Country : US
Telephone Number : 478-918-0770
Fax Number : 478-918-0771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 01/03/2008

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Directions to “ AMIE RENEE DANIELS PA” Practice Location

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