Individual
KIANNA WOOD SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103-6983
(336) 778-7564
Mailing address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103-6983
(336) 778-7564
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-06599
NC
363AM0700X
Medical Physician Assistant
Primary
0010-06599
NC
Other
Enumeration date
07/14/2016
Last updated
12/02/2024
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