Healthcare Provider Details

I. General information

NPI: 1033993365
Provider Name (Legal Business Name): EMILY ELIZABETH BROJ CRNA, DNAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 ASHLEY AVE
CHARLESTON SC
29425-8905
US

IV. Provider business mailing address

2721 CALICO BASS LN
JOHNS ISLAND SC
29455-3181
US

V. Phone/Fax

Practice location:
  • Phone: 224-234-2293
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number240794
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number7842
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: