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NPI Code Detail

MEDICARE: MRS. CRYSTAL GAIL MCDANIEL FNP-C

MEDICARE: MRS. CRYSTAL GAIL MCDANIEL 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
1363LF0000XFamily Nurse Practitioner16458TN

General Provider Information

NPI Number : 1376815415
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CRYSTAL GAIL MCDANIEL FNP-C
Provider Business Mailing Address
First Line : 250 BOSWELL STREET
Second Line :
City : LEXINGTON
State : TN
Zip : 38351-1566
Country : US
Telephone Number : 731-968-2006
Fax Number :
Provider Business Practice Location Address
First Line : 250 BOSWELL STREET
Second Line :
City : LEXINGTON
State : TN
Zip : 38351-1566
Country : US
Telephone Number : 731-968-2006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2012
Last Update Date : 02/06/2012

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Directions to “ MRS. CRYSTAL GAIL MCDANIEL FNP-C” Practice Location

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