Provider Demographics
NPI:1548087760
Name:DANIELS, MARY (APRN-CNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8942 QUIOCCASIN RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5534
Mailing Address - Country:US
Mailing Address - Phone:804-295-4344
Mailing Address - Fax:804-509-0520
Practice Address - Street 1:8942 QUIOCCASIN RD STE 4213
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-5534
Practice Address - Country:US
Practice Address - Phone:804-295-4344
Practice Address - Fax:804-509-0520
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1010634363LP0808X
VA0024191275363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty