Healthcare Provider Details

I. General information

NPI: 1922551746
Provider Name (Legal Business Name): DANIELLE N. LAWRENCE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE N BOUDREAU NP

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 FAYETTEVILLE ST STE 1100
RALEIGH NC
27601-3000
US

IV. Provider business mailing address

421 FAYETTEVILLE ST STE 1100
RALEIGH NC
27601-3000
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2279208
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: