Provider Demographics
NPI:1194142422
Name:STONEBRAKER, DANIELLE ELISABETH (MSN, FNP)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:ELISABETH
Last Name:STONEBRAKER
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:ELISABETH
Other - Last Name:HECHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 VAIL AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1248
Mailing Address - Country:US
Mailing Address - Phone:704-304-7000
Mailing Address - Fax:
Practice Address - Street 1:2001 VAIL AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1248
Practice Address - Country:US
Practice Address - Phone:704-304-7000
Practice Address - Fax:704-304-7008
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC232020363LF0000X
NC5006810363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2741Medicaid
NC1194142422Medicaid
NC1194142422Medicaid
NCNCH966DMedicare PIN
NCNCH966BMedicare PIN
SCNP2741Medicaid