Provider Demographics
NPI:1750462461
Name:SAUNDERS, DEW MATASHA AMANATA (FNP)
Entity Type:Individual
Prefix:MS
First Name:DEW MATASHA
Middle Name:AMANATA
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 E ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2719
Mailing Address - Country:US
Mailing Address - Phone:919-556-1900
Mailing Address - Fax:919-569-3558
Practice Address - Street 1:245 E ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-2719
Practice Address - Country:US
Practice Address - Phone:919-556-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5002188363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2592986Medicare PIN