Provider Demographics
NPI:1134787955
Name:BILICKI, AMY C (FNP-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:BILICKI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5144 HUNTCLIFF TRL
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-4435
Mailing Address - Country:US
Mailing Address - Phone:336-688-4058
Mailing Address - Fax:
Practice Address - Street 1:1255 CREEKSHIRE WAY STE 270
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3061
Practice Address - Country:US
Practice Address - Phone:336-701-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011839363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily