Provider Demographics
NPI:1679857551
Name:ALDRIDGE, EMILY E (AGNP-C)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:E
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 LORI LN
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1728
Mailing Address - Country:US
Mailing Address - Phone:503-464-6765
Mailing Address - Fax:
Practice Address - Street 1:VA SORCC
Practice Address - Street 2:8495 CRATER LAKE HWY
Practice Address - City:WHITE CITY
Practice Address - State:OR
Practice Address - Zip Code:97503
Practice Address - Country:US
Practice Address - Phone:541-826-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201807254RN163W00000X
NC258238163W00000X
NY644642163W00000X
NC5009948363LP2300X
OR201808242NP-PP363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse