Provider Demographics
NPI:1447060595
Name:MCDANIEL, TERYL ANN
Entity type:Individual
Prefix:
First Name:TERYL
Middle Name:ANN
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 MAIN ST N # ND
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-2472
Mailing Address - Country:US
Mailing Address - Phone:701-440-0648
Mailing Address - Fax:
Practice Address - Street 1:1005 MAIN ST N
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-2472
Practice Address - Country:US
Practice Address - Phone:701-440-0648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker