Provider Demographics
NPI:1972834190
Name:MCDANIEL, NICCOLE LYNNE (MSN,ACNP)
Entity Type:Individual
Prefix:
First Name:NICCOLE
Middle Name:LYNNE
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:MSN,ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3442 US HIGHWAY 431
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-0203
Mailing Address - Country:US
Mailing Address - Phone:256-593-1234
Mailing Address - Fax:256-593-6781
Practice Address - Street 1:3442 US HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-0203
Practice Address - Country:US
Practice Address - Phone:256-593-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-084877363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care