Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 5006878 | NC |
NPI | 1013328020 |
---|---|
Provider Name | Katy Demanigold Danford |
First Address | Greensboro, NC 27406-8779 |
Second Address | Greensboro, NC 27406-8779 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2014 |
Last Update Date | 19/09/2018 |