Provider Demographics
NPI:1700396165
Name:COVINGTON, EMILY (NP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:EMILY
Other - Middle Name:JEANNE
Other - Last Name:COVINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:38 ALEVERA ST
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-7019
Mailing Address - Country:US
Mailing Address - Phone:207-807-0088
Mailing Address - Fax:
Practice Address - Street 1:1550 E. WASHINGTON ST., STE 101
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324
Practice Address - Country:US
Practice Address - Phone:909-370-4400
Practice Address - Fax:909-370-4405
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA748070163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice