Provider Demographics
NPI:1093153041
Name:TRIPLETT, ANDREA DAVIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:DAVIS
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:MELISSA
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:WAKE FOREST BAPTIST MEDICAL CTR
Mailing Address - Street 2:MEDICAL CENTER BLVD
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-469-9684
Mailing Address - Fax:
Practice Address - Street 1:WAKE FOREST BAPTIST MEDICAL CTR
Practice Address - Street 2:MEDICAL CENTER BLVD
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-469-9684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC191547390200000X
NC2016-01755208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program