Provider Demographics
NPI:1730559741
Name:ROLFE, DANIELLE MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:ROLFE
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:COWEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:8450 PARK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-5801
Mailing Address - Country:US
Mailing Address - Phone:980-308-0143
Mailing Address - Fax:
Practice Address - Street 1:8450 PARK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-5801
Practice Address - Country:US
Practice Address - Phone:980-308-0143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003452363A00000X, 363AM0700X, 363AS0400X
SC4701363A00000X, 363AS0400X
NC0010-12148363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical