Healthcare Provider Details

I. General information

NPI: 1275814758
Provider Name (Legal Business Name): KIMBERLY LEWIS AGAMEDI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY LEWIS WRIGHT NP

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 OGBURN AVE
WINSTON SALEM NC
27105-2726
US

IV. Provider business mailing address

1175 REVOLUTION MILL DR STE 10
GREENSBORO NC
27405-5080
US

V. Phone/Fax

Practice location:
  • Phone: 336-703-4273
  • Fax: 336-661-4594
Mailing address:
  • Phone: 336-459-3335
  • Fax: 336-450-1980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5005328
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5005328
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: