Provider Demographics
NPI:1013328020
Name:DANFORD, KATY DEMANIGOLD (NP-C)
Entity Type:Individual
Prefix:
First Name:KATY
Middle Name:DEMANIGOLD
Last Name:DANFORD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:DEMANIGOLD
Other - Last Name:BESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:4620 WOODY MILL RD STE G
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8779
Mailing Address - Country:US
Mailing Address - Phone:336-907-3907
Mailing Address - Fax:336-907-3910
Practice Address - Street 1:4620 WOODY MILL RD STE G
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-8779
Practice Address - Country:US
Practice Address - Phone:336-907-3907
Practice Address - Fax:336-907-3910
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006878363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health