Provider Demographics
NPI:1659687309
Name:FUNK, EMILY M (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:M
Last Name:FUNK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:E
Other - Last Name:MCCLANAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:ERWIN RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-620-4917
Mailing Address - Fax:
Practice Address - Street 1:ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-620-4917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC084709367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered