Individual
MRS. PATTY SUSAN VANDERGRIFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NNP-BC
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON-SALEM, NC 27103
(336) 718-3160
Mailing address
1188 MCKNIGHT DRIVE, KING, NC 27021
(336) 983-7338
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5000507
NC
363LN0005X
Critical Care Neonatal Nurse Practitioner
120277
NC
Other
Enumeration date
07/19/2007
Last updated
08/07/2024
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