Healthcare Provider Details

I. General information

NPI: 1235059478
Provider Name (Legal Business Name): DEMB0 KANDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 CRANDON RD
MOUNT HOLLY NC
28120-2507
US

IV. Provider business mailing address

334 CRANDON RD
MOUNT HOLLY NC
28120-2507
US

V. Phone/Fax

Practice location:
  • Phone: 704-606-1620
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number312937
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: