Provider Demographics
NPI:1598194581
Name:DRISKILL, AUDREY CLARK (MS, FNP)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:CLARK
Last Name:DRISKILL
Suffix:
Gender:F
Credentials:MS, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9087
Mailing Address - Country:US
Mailing Address - Phone:919-245-2446
Mailing Address - Fax:919-969-4777
Practice Address - Street 1:300 W TRYON ST
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2438
Practice Address - Country:US
Practice Address - Phone:919-245-2400
Practice Address - Fax:919-644-3007
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-11
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC232606363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily