Provider Demographics
NPI:1609216803
Name:THEBERGE, DANIELLE FECK (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:FECK
Last Name:THEBERGE
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:GRAHAM
Other - Last Name:FECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP
Mailing Address - Street 1:1202 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7307
Mailing Address - Country:US
Mailing Address - Phone:910-341-3300
Mailing Address - Fax:910-815-3141
Practice Address - Street 1:1124 GALLERY PARK LN
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-1142
Practice Address - Country:US
Practice Address - Phone:910-341-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006300163WW0101X, 363LW0102X, 363L00000X
CONP0990745163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health