Healthcare Provider Details

I. General information

NPI: 1487760609
Provider Name (Legal Business Name): EMELIA PAPPOE AMOAKO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 09/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 JUDGES RD STE 4E
WILMINGTON NC
28405-3655
US

IV. Provider business mailing address

311 JUDGES RD STE 4E
WILMINGTON NC
28405-3655
US

V. Phone/Fax

Practice location:
  • Phone: 910-791-6767
  • Fax: 910-791-6890
Mailing address:
  • Phone: 910-791-6767
  • Fax: 910-791-6890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number132022
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN132022
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: