Provider Demographics
NPI:1649879313
Name:STALLINGS, EMILY KEATOR (FNP-CNM)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:KEATOR
Last Name:STALLINGS
Suffix:
Gender:F
Credentials:FNP-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:PRC AND CREDENTIALING
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:21 DIVISION ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5352
Practice Address - Country:US
Practice Address - Phone:401-727-4800
Practice Address - Fax:401-921-6924
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV107542367A00000X
RICNM00202367A00000X
RI367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife