Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 5009439 | NC |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 5009439 | NC |
NPI | 1811421381 |
---|---|
Provider Name | Victoria Ingram Windley |
First Address | Kernersville, NC 27284-9095 |
Second Address | Kernersville, NC 27284-9095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2017 |
Last Update Date | 27/04/2021 |