Healthcare Provider Details

I. General information

NPI: 1083434963
Provider Name (Legal Business Name): ADVANCED MEDICAL CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8025 N POINT BLVD STE 140
WINSTON SALEM NC
27106-3753
US

IV. Provider business mailing address

PO BOX 17365
WINSTON SALEM NC
27116-7365
US

V. Phone/Fax

Practice location:
  • Phone: 336-331-0978
  • Fax: 336-331-0979
Mailing address:
  • Phone: 336-331-0978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JUSTINA OKONKWO
Title or Position: OWNER
Credential: DNP, PMHNP-BC, FNP-C
Phone: 336-414-1214