Provider Demographics
NPI:1205232337
Name:STALLARD, EMILY BARKER (NP-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BARKER
Last Name:STALLARD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 X RAY DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-7489
Mailing Address - Country:US
Mailing Address - Phone:704-867-2341
Mailing Address - Fax:704-867-9019
Practice Address - Street 1:1021 X RAY DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7489
Practice Address - Country:US
Practice Address - Phone:704-867-2341
Practice Address - Fax:704-867-9019
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007310363LA2100X
NC268727363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care