Provider Demographics
NPI:1003516147
Name:MCDANIEL, CHARITY GRANT (NP)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:GRANT
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 WESTOVER HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2959
Mailing Address - Country:US
Mailing Address - Phone:501-266-4317
Mailing Address - Fax:
Practice Address - Street 1:217 WESTOVER HILLS DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2959
Practice Address - Country:US
Practice Address - Phone:501-266-4317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF12220646363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care