Individual
SHEA ROPER GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(828) 971-9777
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-5440
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5019660
NC
363LA2100X
Acute Care Nurse Practitioner
5019660
NC
Other
Enumeration date
02/19/2024
Last updated
02/27/2024
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