Healthcare Provider Details

I. General information

NPI: 1700396165
Provider Name (Legal Business Name): EMILY COVINGTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY JEANNE COVINGTON NP

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 10/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 E. WASHINGTON ST., STE 101
COLTON CA
92324
US

IV. Provider business mailing address

38 ALEVERA ST
IRVINE CA
92618-7019
US

V. Phone/Fax

Practice location:
  • Phone: 909-370-4400
  • Fax: 909-370-4405
Mailing address:
  • Phone: 207-807-0088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number748070
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: