Individual
BRENDA K SANDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
719 GREEN VALLEY RD STE 306, GREENSBORO, NC 27408-7026
(336) 890-2110
(336) 890-2111
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 774-3740
(336) 774-3780
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103254
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8102181
—
NC
Enumeration date
07/22/2006
Last updated
06/13/2025
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