Provider Demographics
NPI:1952300980
Name:EMANUEL, ROBIN KAY (WHNP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:KAY
Last Name:EMANUEL
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 COMMERCE PLAZA CIR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-7386
Mailing Address - Country:US
Mailing Address - Phone:910-521-2900
Mailing Address - Fax:910-775-9165
Practice Address - Street 1:307 E WARDELL DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-7998
Practice Address - Country:US
Practice Address - Phone:910-521-2816
Practice Address - Fax:910-521-3583
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC140912363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1952300980OtherNPI
NC7004941Medicaid
NC7004941Medicaid
NC2599105CMedicare ID - Type UnspecifiedLUMBERTON HEALTH CENTER
NC2599105BMedicare ID - Type UnspecifiedSOUTH ROBESON MEDICAL CTR
NC2599105AMedicare ID - Type UnspecifiedMAXTON MEDICAL CENTER
NCS97739Medicare UPIN