Provider Demographics
NPI:1225797863
Name:MCDANIEL, ALICIA (APRN)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:MENDENHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 MARQUETTE ST
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2508
Mailing Address - Country:US
Mailing Address - Phone:219-462-5195
Mailing Address - Fax:219-548-0945
Practice Address - Street 1:501 MARQUETTE ST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2508
Practice Address - Country:US
Practice Address - Phone:219-462-5195
Practice Address - Fax:219-548-0945
Is Sole Proprietor?:No
Enumeration Date:2021-12-10
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN7014651A363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care