Healthcare Provider Details

I. General information

NPI: 1821907569
Provider Name (Legal Business Name): EMMA ALDRIDGE WOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMMA GRACE ALDRIDGE

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 PRICE ST
MOUNT AIRY NC
27030-4555
US

IV. Provider business mailing address

3534 POPLAR SPRINGS RD
STATE ROAD NC
28676-8845
US

V. Phone/Fax

Practice location:
  • Phone: 336-786-8880
  • Fax:
Mailing address:
  • Phone: 336-366-0766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number333847
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: