Individual
MISS ONITISHA V ANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3821 FORRESTGATE DR, WINSTON SALEM, NC 27103-2930
(336) 448-9100
(336) 778-7995
Mailing address
6940 QUARTER HORSE DR, TRINITY, NC 27370-7864
(989) 737-7620
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
220231
NC
363L00000X
Nurse Practitioner
Primary
5008123
NC
363LA2200X
Adult Health Nurse Practitioner
RN222372
GA
Other
Enumeration date
06/15/2012
Last updated
10/28/2021
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