Healthcare Provider Details

I. General information

NPI: 1073478632
Provider Name (Legal Business Name): EMMA JANE PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DUKE MEDICINE CIR
DURHAM NC
27710-4000
US

IV. Provider business mailing address

DEPT OF SPEECH PATHOLOGY & AUDIOLOGY BOX 3887-DUMC
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-6271
  • Fax:
Mailing address:
  • Phone: 919-684-6271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30002771
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: