Healthcare Provider Details

I. General information

NPI: 1083023428
Provider Name (Legal Business Name): CHRISTINE THORNSBURY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 WESTWOOD AVE SUITE 401
HIGH POINT NC
27262-4341
US

IV. Provider business mailing address

MEDICAL CENTER BLVD SUITE 850
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 336-802-2536
  • Fax: 336-802-2534
Mailing address:
  • Phone: 336-716-2255
  • Fax: 336-716-3202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number224706
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: