Organization
AJELS
Active
Other names
Synapsed Psychiatric Prescribing
Organization subpart
No
Provider details
NPI number
Authorized official
DANYELLE RIDLEY SIMMONS MSN (PMHNP-BC)
(910) 709-4393
Entity
Organization
Contact information
Practice address
208 TRIPLE CROWN DR, RAEFORD, NC 28376-7118
(910) 709-4393
Mailing address
208 TRIPLE CROWN DR, RAEFORD, NC 28376-7118
(910) 709-4393
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184336893
—
NC
Enumeration date
03/08/2025
Last updated
03/08/2025
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