Healthcare Provider Details

I. General information

NPI: 1952300980
Provider Name (Legal Business Name): ROBIN KAY EMANUEL WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 E WARDELL DR
PEMBROKE NC
28372-7998
US

IV. Provider business mailing address

60 COMMERCE PLAZA CIR
PEMBROKE NC
28372-7386
US

V. Phone/Fax

Practice location:
  • Phone: 910-521-2816
  • Fax: 910-521-3583
Mailing address:
  • Phone: 910-521-2900
  • Fax: 910-775-9165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number140912
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: