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General NPI Number Information
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NPI Number | 1730094541
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Entity Type | Individual
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Provider Name | ALISHA LYNN FAMIGLIETTI PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 475 VINE ST STE 130
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City | WINSTON SALEM
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State | NC
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Zip | 27101-4135
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Country | US
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Telephone | 603-769-0196
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Fax |
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Provider Business Mailing Address
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Address Line | 336 FLOWER HOUSE LOOP
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City | TROUTMAN
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State | NC
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Zip | 28166-8703
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Country | US
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Telephone | 603-769-0196
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-16875
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License Number State | NC
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