Healthcare Provider Details

I. General information

NPI: 1083925770
Provider Name (Legal Business Name): SARAH EDMUNDSON TRIMBLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E WENDOVER AVE STE 300
GREENSBORO NC
27401-1231
US

IV. Provider business mailing address

301 E WENDOVER AVE STE 300
GREENSBORO NC
27401-1231
US

V. Phone/Fax

Practice location:
  • Phone: 336-268-3380
  • Fax:
Mailing address:
  • Phone: 336-268-3380
  • Fax: 336-268-3381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5018034
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number3006465
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number5018034
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: