Jacqueline Charmaine Daniels, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11007495 Issued in FL

Practice address

107 W 19TH St
Panama City, FL 32405-4647

Phone

(850) 769-3040

NPI assigned

Jun 10, 2020

Last updated

Aug 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628380800000",
    "number": "1275158701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 IOWA AVE",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324441944",
            "telephone_number": "850-630-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W 19TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054647",
            "telephone_number": "850-769-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "JACQUELINE",
        "middle_name": "CHARMAINE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2021-08-08",
        "certification_date": "2021-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Willoughby Dame, BC-HIS
• Damon Labarbera, PHD
• Daniel C Daube Jr MD LLC (Gulf Coast Facial Plastics & E.N.T. Center)
• Ashley Daniels
• Fern Daniels
• Jennifer Daniels
• Kristjona Daniels
• Katie M Danielson, ARNP
• Robin Keith Darling, D.D.S.
• Heather S Darnell, FNP-C

• Family Nurse Practitioner in Panama City, FL
• Providers in Panama City, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.