Provider Demographics
NPI:1225706344
Name:MEARS, EMILY JOSEPHINE (FNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:JOSEPHINE
Last Name:MEARS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:JOSEPHINE
Other - Last Name:HUMISTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4358
Mailing Address - Country:US
Mailing Address - Phone:704-874-1904
Mailing Address - Fax:
Practice Address - Street 1:1022 SHELTON AVE
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-6826
Practice Address - Country:US
Practice Address - Phone:704-768-2080
Practice Address - Fax:704-768-2085
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily