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Organization

AJELS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANYELLE RIDLEY SIMMONS MSN, NP (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
(472) 215-8596

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
03/10/2025
Last updated
09/10/2025
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