Provider Demographics
NPI:1932465069
Name:MCNAIR, EMILIE M (NP)
Entity Type:Individual
Prefix:MS
First Name:EMILIE
Middle Name:M
Last Name:MCNAIR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3009 WAUGHTOWN ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-1634
Mailing Address - Country:US
Mailing Address - Phone:336-293-8728
Mailing Address - Fax:336-293-8733
Practice Address - Street 1:3009 WAUGHTOWN ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27107-1634
Practice Address - Country:US
Practice Address - Phone:336-293-8728
Practice Address - Fax:336-293-8733
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5005598363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7006474Medicaid
NCNC1238AMedicare PIN