Provider Demographics
NPI:1184763849
Name:WALDEN, EMILY FRANCIS (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:FRANCIS
Last Name:WALDEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:FRANCIS
Other - Last Name:MOUNTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1506 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-4871
Mailing Address - Country:US
Mailing Address - Phone:910-254-4065
Mailing Address - Fax:910-254-4067
Practice Address - Street 1:1506 MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-4871
Practice Address - Country:US
Practice Address - Phone:910-254-4065
Practice Address - Fax:910-254-4067
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00756363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant