# NOVANT HEALTH KERNERSVILLE OUTPATIENT SURGERY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750892659
- **Authorized official:** JENNIFER LYNN O'BRIEN (ADMINISTRATOR ASC)
- **Authorized official phone:** (336) 564-4938

## Contact information

- **Practice address:** 1730 KERNERSVILLE MEDICAL PKWY STE 304, KERNERSVILLE, NC 27284-7198
- **Practice address phone:** (336) 564-4938
- **Mailing address:** 2085 FRONTIS PLAZA BLVD, WINSTON SALEM, NC 27103-5614
- **Mailing address phone:** (336) 515-7000
- **Mailing address fax:** (336) 515-7009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/18/2017
- **Last updated:** 01/02/2020