Provider Demographics
NPI:1699509372
Name:LANKFORD, DANIEL (NP)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:LANKFORD
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ROCKY BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-3050
Mailing Address - Country:US
Mailing Address - Phone:678-873-0574
Mailing Address - Fax:
Practice Address - Street 1:7129 FLOYD ST NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-1578
Practice Address - Country:US
Practice Address - Phone:678-660-3366
Practice Address - Fax:678-712-9553
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN274481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily