Provider Demographics
NPI:1649830886
Name:TULLY, EMILY FREDRICKS (DNP, ARNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:FREDRICKS
Last Name:TULLY
Suffix:
Gender:F
Credentials:DNP, ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 KENSINGTON PL APT E
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2383
Mailing Address - Country:US
Mailing Address - Phone:828-329-3507
Mailing Address - Fax:
Practice Address - Street 1:709 N JUSTICE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3454
Practice Address - Country:US
Practice Address - Phone:828-696-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013997363LF0000X
WAAP60975350363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily