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Kellie Duvall Souther
Nurse Practitioner in Mocksville, North Carolina
NPI 1558846527

Kellie Duvall Souther is a Nurse Practitioner based in Winston Salem, NC. Kellie Duvall Souther practices in Mocksville, NC. The NPI Number for Kellie Duvall Souther is 1558846527 and holds a License No. 5011023 (North Carolina).

The current practice location address for Kellie Duvall Souther is 1188 Yadkinville Rd, Mocksville, NC and can be reached out via phone at 336-716-7435 and via fax at 336-702-9277.

Location: 1188 Yadkinville Rd, Mocksville, NC, 27103-6074
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558846527
Provider Name
Kellie Duvall Souther
Credential
Provider Entity Type
Individual
Gender
Female
Address
1188 Yadkinville Rd, Mocksville, NC, 27103-6074
Phone Number
336-716-7435
Fax Number
336-702-9277
Provider Enumeration Date
09/26/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1188 Yadkinville Rd
City
Mocksville
State
North Carolina
Zip
27028-2037
Phone Number
336-716-7435
Fax Number
336-702-9277
person
Provider Business Mailing Address Details
Address
1188 Yadkinville Rd
City
Mocksville
State
North Carolina
Zip
27028-2037
Phone Number
336-716-7435
Fax Number
336-702-9277
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
5011023 (North Carolina)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
5011023 (North Carolina)
Definition
Definition to come...
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