Provider Demographics
NPI:1235963778
Name:STADLER, DANIELLE EMILY (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:EMILY
Last Name:STADLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-721-2375
Mailing Address - Fax:336-721-2394
Practice Address - Street 1:390 W SALEM AVE
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-5861
Practice Address - Country:US
Practice Address - Phone:336-721-2375
Practice Address - Fax:336-721-2394
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-14779363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant