Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 5015367 | NC |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 5015367 | NC |
NPI | 1013673987 |
---|---|
Provider Name | Bridgett Amanda Saliba |
First Address | Winston Salem, NC 27157-6074 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2021 |
Last Update Date | 19/01/2022 |