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General NPI Number Information
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NPI Number | 1003798018
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Entity Type | Individual
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Provider Name | DANIELLE SOUTENDIJK FNP
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Gender | Female
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 901 US 70 HWY W STE 100
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City | GARNER
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State | NC
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Zip | 27529-2664
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Country | US
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Telephone | 919-977-7095
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Fax | 919-977-9289
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Provider Business Mailing Address
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Address Line | 901 US 70 HWY W STE 100
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City | GARNER
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State | NC
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Zip | 27529-2664
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Country | US
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Telephone | 919-977-7095
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Fax | 919-977-9289
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5022732
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License Number State | NC
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