Provider Demographics
NPI:1912241514
Name:SPEARS, EMILY ANN (CPNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:SPEARS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANN
Other - Last Name:ZGORSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNA
Mailing Address - Street 1:5900 WATERLOO RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2639
Mailing Address - Country:US
Mailing Address - Phone:443-451-1600
Mailing Address - Fax:
Practice Address - Street 1:5900 WATERLOO RD
Practice Address - Street 2:SUITE 110
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2639
Practice Address - Country:US
Practice Address - Phone:443-451-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR200773363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics