104027
Active
No
06/16/2004
06/10/2027
Active Supervisor
North Carolina Hospital Admitting Privileges
| Location |
| Novant Health Forsyth Medical Center |
| Novant Health Kernersville Medical Center |
Out of State Active/Inactive Licenses
Out of Country Active/Inactive Licenses
Address
Novant Health GoHealth Clemmons
3163 Gammon Lane
Clemmons, NC 27012
336-310-5571
Information
PA School
| School | Graduation |
| Wake Forest University School of Medicine Physician Assistant Program | 2004 |
Area of Practice
| Area Of Practice | Primary |
| Emergency Medicine | Yes |
Current Membership in Medical Professional Organizations
| Membership |
| American Association of Physician Assistants (AAPA) |
Honors & Awards
| Honor/Award | Given By | Date |
| None Reported |
Public Service
| Name of Clinic | Service Description | Date |
| None Reported |
Current Academic Appointments
| Title | Institution | City, State, Country |
| None Reported |
Publications
Section 1: Adverse Actions
North Carolina Medical Board Public Actions
| Date | Description | Link |
| None Reported |
Other Regulatory Board or Agency Public Actions
| Date | Name of Board/Agency | Action Taken | Link |
| None Reported |
Health Care Institution Suspensions and Revocations
| Date | Health Care Institution | Action Taken |
| None Reported |
Section 2: Administrative Actions
Actions listed in this section are considered non-disciplinary by the Board. In situations where
administrative actions are taken, the licensee may not have met certain statutory requirements or
may have failed to follow correct administrative procedures.
North Carolina Medical Board Reentry Agreement
| Date | Description | Link |
| None Reported |
North Carolina Special Purpose Licensing Agreement
| Date | Description | Link |
| None Reported |
Malpractice Information
The Board is currently reviewing the care that led to this payment.
| Incident Date | Payment Date | Area of Practice | City, State, Country | Response |
| None Reported |
Misdemeanor/DUI/DWI Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |
Felony Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |