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General NPI Number Information
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NPI Number | 1285655266
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Entity Type | Individual
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Provider Name | BRENDA K SANDRIDGE PA
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Gender | Female
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 719 GREEN VALLEY RD STE 306
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City | GREENSBORO
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State | NC
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Zip | 27408-7026
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Country | US
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Telephone | 336-890-2110
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Fax | 336-890-2111
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Provider Business Mailing Address
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Address Line | PO BOX 751803
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City | CHARLOTTE
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State | NC
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Zip | 28275-1803
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Country | US
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Telephone | 336-774-3740
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Fax | 336-774-3780
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 103254
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License Number State | NC
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