Individual
DANIELLE SURRELLS KEEVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1900 S HAWTHORNE RD, SUITE 312, WINSTON SALEM, NC 27103-3913
(336) 718-3960
(336) 718-3998
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 718-3960
(336) 718-3998
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0050-02194
NC
363L00000X
Nurse Practitioner
Primary
5002194
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193344
MEDCOST
NC
05
—
7003959
—
NC
01
—
7110891
AETNA
NC
Enumeration date
11/29/2006
Last updated
08/05/2024
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