2012-02208
Active
No
11/16/2012
04/22/2027
Active Supervisees
| Name | Type | Status | Approved | Inactive |
|
Anderson, Elizabeth
| Nurse Practitioner |
Active
|
09/27/2023
|
|
|
Berger, Allison Clarke
| Nurse Practitioner |
Active
|
07/02/2023
|
|
|
Brewer, Jennifer Fichera
| Physician Assistant |
Active
|
06/20/2024
|
|
|
Cramer, Mary Suzanne
| Nurse Practitioner |
Active
|
01/31/2024
|
|
|
Gargano, Emily
| Nurse Practitioner |
Active
|
02/03/2026
|
|
|
Green, Matthew Steven
| Physician Assistant |
Active
|
06/03/2022
|
|
|
Haskins, Kaila
| Nurse Practitioner |
Active
|
09/17/2023
|
|
|
Haymore White, Jennifer Lynn
| Nurse Practitioner |
Active
|
09/25/2025
|
|
|
Hostetter, Sheila Lynn
| Nurse Practitioner |
Active
|
06/29/2022
|
|
|
Hulsman, Matthew John
| Nurse Practitioner |
Active
|
02/23/2024
|
|
|
Ingram Curtis, Jacinta Kara
| Nurse Practitioner |
Active
|
09/27/2022
|
|
|
Joyce, Sunny Marie
| Nurse Practitioner |
Active
|
09/25/2023
|
|
|
Kidd, Domiziana
| Physician Assistant |
Active
|
07/16/2024
|
|
|
Kothari, Amoli Anand
| Physician Assistant |
Active
|
11/14/2025
|
|
|
Lawson, Alexandra Leigh
| Physician Assistant |
Active
|
06/29/2023
|
|
|
Lowery, Kelley Lauren
| Physician Assistant |
Active
|
12/13/2023
|
|
|
Mabe, Dana Stewart
| Nurse Practitioner |
Active
|
05/02/2023
|
|
|
Maderia, Amanda Catherine
| Nurse Practitioner |
Active
|
01/16/2024
|
|
|
Manuel, Kelley Osborne
| Nurse Practitioner |
Active
|
03/05/2025
|
|
|
Mclean, Ta'shayveon Mon'shay
| Nurse Practitioner |
Active
|
08/13/2026
|
|
|
Moore, Taylor Erin
| Physician Assistant |
Active
|
12/05/2023
|
|
|
Mullane, Marilyn Kay
| Physician Assistant |
Active
|
12/04/2021
|
|
|
Pulliam, Meredith Mcdaniel
| Physician Assistant |
Active
|
05/08/2023
|
|
|
Roy, Deborah Lee
| Nurse Practitioner |
Active
|
01/28/2024
|
|
|
Spurling, Rebecca
| Nurse Practitioner |
Active
|
10/31/2023
|
|
|
Starke, Teresa Anne
| Physician Assistant |
Active
|
03/21/2023
|
|
|
Sullivan, Benjamin Jacob
| Physician Assistant |
Active
|
07/23/2026
|
|
|
Weekley, Melanie Chase
| Physician Assistant |
Active
|
12/17/2021
|
|
|
West, Joseph Benjamin
| Nurse Practitioner |
Active
|
01/29/2023
|
|
North Carolina Hospital Admitting Privileges
| Location |
| Wake Forest Baptist Medical Center |
| Wake Forest University |
Out of State Active/Inactive Licenses
Out of Country Active/Inactive Licenses
| Country |
| Kenya |
| Macedonia (the former Yugoslav Republic of) |
| Tanzania, United Republic of |
| Zimbabwe |
Address
Wake Forest University Baptist Medical Center
Department of Emergency Medicine
Medical Center Blvd
Winston-Salem, NC 27157
336-716-1503
Information
Medical School
| School | Graduation |
| Kansas City University of Medicine and Biosciences | 2009 |
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 |
| Wake Forest University | Other - Pediatric Emergency Medicine |
NC, US
| Fellowship | 2014 |
| Wake Forest University | Emergency Medicine |
NC, US
| Residency | 2012 |
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 |
| Emergency Medicine | 2013 |
| Pediatric Emergency Medicine | 2015 |
Area of Practice
| Area Of Practice | Primary |
| Emergency Medicine | |
| Pediatric - Emergency Medicine | Yes |
Current Membership in Medical Professional Organizations
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 |