MEDICARE: STEPHANIE ANNE MCDANIEL CNP

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	COA.13886-NP	OH

General Provider Information

NPI Number	:	1255681193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ANNE MCDANIEL CNP

Provider Business Mailing Address
First Line	:	6680 PERIMETER DR
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-8030
Country	:	US
Telephone Number	:	614-792-5200
Fax Number	:

Provider Business Practice Location Address
First Line	:	6680 PERIMETER DR
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-8030
Country	:	US
Telephone Number	:	614-792-5200
Fax Number	:

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

Provider Enumeration Date	:	09/19/2012
Last Update Date	:	05/06/2013

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