Provider Demographics
NPI:1477225100
Name:MURRY, EMMA CAROLINE
Entity type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:CAROLINE
Last Name:MURRY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:EMMA
Other - Middle Name:CAROLINE
Other - Last Name:MURRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-718-6199
Mailing Address - Fax:336-719-6190
Practice Address - Street 1:2025 FRONTIS PLAZA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-5663
Practice Address - Country:US
Practice Address - Phone:336-718-6199
Practice Address - Fax:336-719-6190
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017939363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner