Daniel, Jacquelin S

Daniel, Jacquelin S is an individual health care provider with primary practice located at 1508 K-V Road , Victoria VA 23974. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Daniel, Jacquelin S can be contacted via phone (434) 696-2165.

Contact Information

Primary practice address
1508 K-V Road Victoria VA 23974
Phone: (434) 696-2165
Fax: (434) 696-1577
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024164095 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 0024164095 Virginia

Profile Details

NPI number 1083619563
LBN Legal business name Daniel, Jacquelin S
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Oct 11th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083619563 NPPES
Virginia Other 7000967 NC MEDICAID
Virginia Other 187699 NC MEDICAID
Virginia Other 187620 NC MEDICAID
Virginia MEDICAID 010025788 NC MEDICAID
Virginia MEDICAID 010252881 NC MEDICAID
Virginia Other 010025788 NC MEDICAID
Virginia Other 010105510 NC MEDICAID
Virginia Other 187697 NC MEDICAID
Virginia Other 224189800 NC MEDICAID
Virginia MEDICAID 010105510 NC MEDICAID

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