Provider Demographics
NPI:1144415563
Name:EMUNAH, JOSEPHINE (MS, RD)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:EMUNAH
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28360-9494
Mailing Address - Country:US
Mailing Address - Phone:910-671-3270
Mailing Address - Fax:910-671-3484
Practice Address - Street 1:460 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28360-9494
Practice Address - Country:US
Practice Address - Phone:910-671-3270
Practice Address - Fax:910-671-3484
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC941234133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered