Provider Demographics
NPI:1477225100
Name:MURRY, EMMA CAROLINE
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:CAROLINE
Last Name:MURRY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:EMMA
Other - Middle Name:CAROLINE
Other - Last Name:MURRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1601 GREENE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29208-4001
Mailing Address - Country:US
Mailing Address - Phone:803-777-7412
Mailing Address - Fax:
Practice Address - Street 1:725 HIGHLAND OAKS DR STE 200
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-7109
Practice Address - Country:US
Practice Address - Phone:336-718-6199
Practice Address - Fax:336-718-6190
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017939363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner