Healthcare Provider Details

I. General information

NPI: 1235362450
Provider Name (Legal Business Name): DANYELLE LEIGH WILLIAMS RN,BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2009
Last Update Date: 09/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2022 KEDVALE AVE
RALEIGH NC
27617-4285
US

IV. Provider business mailing address

2022 KEDVALE AVE
RALEIGH NC
27617-4285
US

V. Phone/Fax

Practice location:
  • Phone: 919-800-1330
  • Fax:
Mailing address:
  • Phone: 919-800-1330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number223064
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: