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Licensee Information

Cassandra Nebosky-Diaz - PA-C
0010-08461
Active
No
09/19/2018
07/26/2027

Active Supervisor

NameTypeStatusApprovedInactive
Mardis, Stacey Leigh, MD MD Active 03/09/2023
Misenar, Garik Traverse, MD MD Active 02/08/2021
Wyatt, Elijah Caleb, MD MD Active 09/10/2024
Xiong, Shane, DO DO Active 09/11/2024

North Carolina Hospital Admitting Privileges

Location
Novant Health Kernersville Medical Center
Southeastern Regional Medical Center

Out of State Active/Inactive Licenses

State
Tennessee

Out of Country Active/Inactive Licenses

Country
None Reported

Address

Brunswick Physician Partners, LLC
240 Hospital Dr. NE
Bolivia, NC 28422

Information

PA School

SchoolGraduation
Campbell University Physician Assistant Program2018

Area of Practice

Area Of PracticePrimary
Emergency MedicineYes
Telemedicine 

Current Membership in Medical Professional Organizations

Membership
None Reported

Honors & Awards

Honor/AwardGiven ByDate
None Reported

Public Service

Name of ClinicService DescriptionDate
None Reported

Current Academic Appointments

TitleInstitutionCity, State, Country
None Reported

Publications

Title
None Reported

Section 1: Adverse Actions

North Carolina Medical Board Public Actions

DateDescriptionLink
None Reported

Other Regulatory Board or Agency Public Actions

DateName of Board/AgencyAction TakenLink
None Reported

Health Care Institution Suspensions and Revocations

DateHealth Care InstitutionAction 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

DateDescriptionLink
None Reported

North Carolina Special Purpose Licensing Agreement

DateDescriptionLink
None Reported

Malpractice Information

The Board is currently reviewing the care that led to this payment.

Incident DatePayment DateArea of PracticeCity, State, CountryResponse
None Reported

Misdemeanor/DUI/DWI Conviction Information

Conviction DateConvictionJurisdictionSentence
None Reported

Felony Conviction Information

Conviction DateConvictionJurisdictionSentence
None Reported
Information loaded from this database is current as of 7/29/2026 7:56:44 AM

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