MEDICARE: AMY D DANIEL FNP-C

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
1	363LF0000X	Family Nurse Practitioner	RN198744	GA

General Provider Information

NPI Number	:	1235478025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY D DANIEL FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 307
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30028-0307
Country	:	US
Telephone Number	:	770-887-1668
Fax Number	:

Provider Business Practice Location Address
First Line	:	775 WEST AVE STE A
Second Line	:
City	:	CARTERSVILLE
State	:	GA
Zip	:	30120-3482
Country	:	US
Telephone Number	:	470-315-4689
Fax Number	:	470-315-4916

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2013
Last Update Date	:	03/03/2022

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