Provider Demographics
NPI:1841274719
Name:EMERSON, PAMELA KAYE (CRNA, MSN)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:KAYE
Last Name:EMERSON
Suffix:
Gender:F
Credentials:CRNA, MSN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751730
Mailing Address - Street 2:WAKE FOREST UNIVERSITY BAPTIST MEDICAL CTR
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-0001
Mailing Address - Country:US
Mailing Address - Phone:336-225-4413
Mailing Address - Fax:
Practice Address - Street 1:WAKE FOREST UNIVERSITY BAPTIST MEDICAL CTR
Practice Address - Street 2:MEDICAL CENTER BLVD
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-225-4413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC44164367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1841274719OtherRALIROAD # P00249127
NC8049928Medicaid
NC2628220FMedicare PIN