Provider Demographics
NPI:1407555857
Name:SHUMATE, EMILY MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:SHUMATE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28697-2854
Mailing Address - Country:US
Mailing Address - Phone:336-651-7460
Mailing Address - Fax:336-651-7813
Practice Address - Street 1:306 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-2854
Practice Address - Country:US
Practice Address - Phone:336-651-7460
Practice Address - Fax:336-651-7813
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017868363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner