Provider Demographics
NPI:1285058446
Name:MCDANIEL, JEANNE BAKER (MS, RDN, LD)
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:BAKER
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 DARTMOOR CIR
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-1902
Mailing Address - Country:US
Mailing Address - Phone:404-725-7101
Mailing Address - Fax:
Practice Address - Street 1:289 DARTMOOR CIR
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-1902
Practice Address - Country:US
Practice Address - Phone:404-725-7101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-09
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD001713133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric