Provider Demographics
NPI:1386927283
Name:MCDANIEL, JAMES G (EDD, ARNP, MBA)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:MCDANIEL
Suffix:
Gender:M
Credentials:EDD, ARNP, MBA
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:GOODLETT
Other - Last Name:MCDANIEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:1601 SW ARCHER RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1135
Mailing Address - Country:US
Mailing Address - Phone:800-324-8387
Mailing Address - Fax:352-374-6113
Practice Address - Street 1:1601 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1135
Practice Address - Country:US
Practice Address - Phone:800-324-8387
Practice Address - Fax:352-374-6113
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171348363LP0808X
VA0015000181364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health