Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Oct 23, 2023
License(s)
5019458 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2419 GRIFFITH MEADOWS DR | Winston Salem, NC 27103-6300 | 704-492-4375 |
| MAILING | 2419 GRIFFITH MEADOWS DR | Winston Salem, NC 27103-6300 | 704-492-4375 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.