Provider Demographics
NPI:1265972913
Name:FIELDS, EMILY NICHOLE (NP-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:NICHOLE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-3145
Mailing Address - Country:US
Mailing Address - Phone:276-783-7154
Mailing Address - Fax:
Practice Address - Street 1:110 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-3145
Practice Address - Country:US
Practice Address - Phone:276-783-7154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily