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Individual

TRAVIS MAURICE RADCLIFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4115 CRESTWOOD CIR, WINSTON SALEM, NC 27107-3788
(850) 699-3842
Mailing address
4115 CRESTWOOD CIR, WINSTON SALEM, NC 27107-3788

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
248905
NC
363L00000X
Nurse Practitioner
5021808
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5021808
NC

Other

Enumeration date
05/20/2020
Last updated
01/07/2026
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