Provider Demographics
NPI:1851964845
Name:KOERPER, EMMA CHRISTINE (FNP-C)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:CHRISTINE
Last Name:KOERPER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:CHRISTINE
Other - Last Name:MICHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:370 ROSE BUD LN
Mailing Address - Street 2:
Mailing Address - City:HOLLY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28445-7951
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13741 NC HIGHWAY 50 STE A
Practice Address - Street 2:
Practice Address - City:SURF CITY
Practice Address - State:NC
Practice Address - Zip Code:28445-6935
Practice Address - Country:US
Practice Address - Phone:910-777-2732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014748363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily