Provider Demographics
NPI:1013525849
Name:WEGENKA, EMILY CAROLINE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CAROLINE
Last Name:WEGENKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 CATTLE DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:NC
Mailing Address - Zip Code:28789-7074
Mailing Address - Country:US
Mailing Address - Phone:828-506-0021
Mailing Address - Fax:
Practice Address - Street 1:1 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719
Practice Address - Country:US
Practice Address - Phone:828-497-9163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013201363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner