Provider Demographics
NPI:1689087678
Name:WOOD, DANIELLE (NP-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 BRIARWOOD DR STE A
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-5497
Mailing Address - Country:US
Mailing Address - Phone:828-672-1101
Mailing Address - Fax:828-294-0075
Practice Address - Street 1:1940 BRIARWOOD DR STE A
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602
Practice Address - Country:US
Practice Address - Phone:828-672-1101
Practice Address - Fax:828-294-0075
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28177944A363L00000X
NC5007930363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner