Provider Demographics
NPI:1942085709
Name:PEDEN, EMILY ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ELIZABETH
Last Name:PEDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ELIZABETH
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1613 FIVE FORKS RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-4321
Mailing Address - Country:US
Mailing Address - Phone:757-301-1743
Mailing Address - Fax:
Practice Address - Street 1:1613 FIVE FORKS RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-4321
Practice Address - Country:US
Practice Address - Phone:757-301-1743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula