Provider Demographics
NPI:1942486204
Name:MCDANIEL, STACY REBECCA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:REBECCA
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 ROSELANE ST NW
Mailing Address - Street 2:SUITE 710
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6913
Mailing Address - Country:US
Mailing Address - Phone:770-281-5115
Mailing Address - Fax:678-581-7111
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1152
Practice Address - Country:US
Practice Address - Phone:404-778-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0231901835X0200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835X0200XPharmacy Service ProvidersPharmacistOncology