24703
Active
No
10/11/1980
04/30/2027
Active Supervisees
| Name | Type | Status | Approved | Inactive |
|
Beall, Stephanie Alyse
| Nurse Practitioner |
Active
|
09/22/2025
|
|
|
Black, Eyanna Thompson
| Nurse Practitioner |
Active
|
01/21/2025
|
|
|
Britton, Wendy Witherow
| Nurse Practitioner |
Active
|
11/03/2015
|
|
|
Cox, Vanessa Bell
| Physician Assistant |
Active
|
11/10/2014
|
|
|
Craddock, Latara Kichelle
| Nurse Practitioner |
Active
|
10/21/2025
|
|
|
Faucette, Deonna Lynn
| Physician Assistant |
Active
|
05/20/2025
|
|
|
Galloway, Shatazamine Shannette
| Nurse Practitioner |
Active
|
08/02/2026
|
|
|
Grandis, Caroline Golden
| Nurse Practitioner |
Active
|
08/20/2009
|
|
|
Hines, Dana Lee
| Nurse Practitioner |
Active
|
04/06/2025
|
|
|
Ibrahim, Sadou
| Nurse Practitioner |
Active
|
10/13/2011
|
|
|
Jalloh, Jeneba
| Nurse Practitioner |
Active
|
04/26/2026
|
|
|
Knight, Brandi Michelle
| Nurse Practitioner |
Active
|
10/16/2019
|
|
|
Kraus, Andrea Hope
| Nurse Practitioner |
Active
|
09/10/2018
|
|
|
Linville, Kristi Gayle
| Nurse Practitioner |
Active
|
08/04/2016
|
|
|
Locke, Shaw Timothy
| Physician Assistant |
Active
|
02/11/2025
|
|
|
Mccorkle, Tenika Chique
| Nurse Practitioner |
Active
|
10/18/2021
|
|
|
Mccormick, Lindsey Anne
| Nurse Practitioner |
Active
|
10/05/2022
|
|
|
Nicholson, Yolanda Mcclam
| Nurse Practitioner |
Active
|
05/18/2021
|
|
|
Ryan, Heather
| Nurse Practitioner |
Active
|
03/06/2026
|
|
|
Slocum, Amanda Bates
| Nurse Practitioner |
Active
|
11/18/2021
|
|
|
Spicer, Christen Catoe
| Nurse Practitioner |
Active
|
09/19/2021
|
|
|
Warren, John Frank
| Physician Assistant |
Active
|
06/12/2026
|
|
|
Williams, Christine Veiga
| Physician Assistant |
Active
|
05/21/2025
|
|
|
Zook, Kathryn Anne
| Nurse Practitioner |
Active
|
07/11/2026
|
|
North Carolina Hospital Admitting Privileges
| Location |
| Forsyth Medical Center |
Out of State Active/Inactive Licenses
Out of Country Active/Inactive Licenses
Address
Ardmore Family Practice, PA
2805 Lyndhurst Ave
Winston-Salem, NC 27103-4109
336-659-0076
ardmorefamilypractice.com
Information
Monday-Friday, Saturday mornings
Yes
Yes
Yes
Yes
Yes
Medical School
| School | Graduation |
| Univ Pittsburgh | 1979 |
Post Graduate Training
"Last Year" does not necessarily mean that the licensee completed his/her training program. (In NC, a physician can be licensed without completing such a program.)
| Institution | Specialty | State, Country | Training Program | Last Year |
| NC Baptist Hospital | Family Medicine |
NC, US
| Residency | 1982 |
Current Board Certification and Year of Certification/Recertification
Physicians should not list non-ABMS or non-AOA specialty boards unless the board meets the criteria set forth in the NC Medical Board’s Advertising and Publicity Position Statement.
| Primary/Subspecialty | Year |
| Family Medicine | 2017 |
Area of Practice
| Area Of Practice | Primary |
| Family Medicine | Yes |
Current Membership in Medical Professional Organizations
| Membership |
| American Academy of Family Physicians |
| NC Academy of Family Physicians |
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 |