Provider Demographics
NPI:1174946149
Name:MCDANIEL, SHARON (NP-C)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 OFFICE PARK DR STE OFFICE
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-7534
Mailing Address - Country:US
Mailing Address - Phone:501-539-6836
Mailing Address - Fax:501-943-8022
Practice Address - Street 1:408 OFFICE PARK DR STE 2
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-7536
Practice Address - Country:US
Practice Address - Phone:501-539-6836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR122456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily