Individual
KANDIS DANIELLE FORDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
556 SANDHURST DR, FAYETTEVILLE, NC 28304-4426
(910) 483-2646
Mailing address
556 SANDHURST DR, FAYETTEVILLE, NC 28304-4426
(910) 483-2646
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
0010-07636
NC
363A00000X
Physician Assistant
Primary
0010-07636
NC
Other
Enumeration date
10/04/2017
Last updated
04/08/2026
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