Individual
MISS COURTNEY ROHAN ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-7080
(336) 718-9622
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 718-7080
(336) 718-9622
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-03596
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-03596
NC LICENSE
NC
Enumeration date
06/21/2012
Last updated
10/25/2020
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