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General NPI Number Information
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NPI Number | 1134787955
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Entity Type | Individual
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Provider Name | AMY C BILICKI FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 1255 CREEKSHIRE WAY STE 270
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3061
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Country | US
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Telephone | 336-701-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 5144 HUNTCLIFF TRL
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City | WINSTON SALEM
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State | NC
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Zip | 27104-4435
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Country | US
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Telephone | 336-688-4058
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5011839
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License Number State | NC
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