Healthcare Provider Details

I. General information

NPI: 1568927085
Provider Name (Legal Business Name): AMANDA LEIGH WRIGHT MSN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 SILAS CREEK PKWY
WINSTON SALEM NC
27103-3013
US

IV. Provider business mailing address

PO BOX 60516
CHARLOTTE NC
28260-0516
US

V. Phone/Fax

Practice location:
  • Phone: 336-718-5570
  • Fax: 336-718-5569
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5011374
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5011374
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: