Healthcare Provider Details

I. General information

NPI: 1811852197
Provider Name (Legal Business Name): EMILY STUMP NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 PROFESSIONAL PARK DR STE D
MOORESVILLE NC
28117-6541
US

IV. Provider business mailing address

137 PROFESSIONAL PARK DR STE D
MOORESVILLE NC
28117-6541
US

V. Phone/Fax

Practice location:
  • Phone: 828-608-0892
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025066013
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: