Provider Demographics
NPI:1164153060
Name:EMERSON, ELIZABETH FAITH (PNP-PC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:FAITH
Last Name:EMERSON
Suffix:
Gender:F
Credentials:PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 DALY CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-1598
Mailing Address - Country:US
Mailing Address - Phone:321-505-1961
Mailing Address - Fax:
Practice Address - Street 1:400 W RANSOM ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2434
Practice Address - Country:US
Practice Address - Phone:919-756-1794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016398208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics