Healthcare Provider Details

I. General information

NPI: 1316759392
Provider Name (Legal Business Name): DANIELLE BRANDENBURG CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 S MAIN ST STE 210
HOLLY SPRINGS NC
27540-6053
US

IV. Provider business mailing address

15 RAWLS MEADOW LN
FUQUAY VARINA NC
27526-3780
US

V. Phone/Fax

Practice location:
  • Phone: 919-924-8261
  • Fax:
Mailing address:
  • Phone: 919-924-8261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number5021553
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: