Individual
DESHANNON DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
524 SIGNAL HILL DRIVE EXT, STATESVILLE, NC 28625-4391
(704) 871-9605
Mailing address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
72506
NC
Other
Enumeration date
03/26/2019
Last updated
03/26/2019
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