Provider Demographics
NPI:1003432790
Name:MCDANIEL, JOSHUA LEE (NP)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:LEE
Last Name:MCDANIEL
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-564-4445
Mailing Address - Fax:336-992-3240
Practice Address - Street 1:1730 KERNERSVILLE MEDICAL PKWY STE 203
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7198
Practice Address - Country:US
Practice Address - Phone:336-564-4445
Practice Address - Fax:336-992-3240
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014458363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily