MEDICARE: MS. EMILIE M MCNAIR N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5005598	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932465069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMILIE M MCNAIR N.P.

Provider Business Mailing Address
First Line	:	3009 WAUGHTOWN ST
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27107-1634
Country	:	US
Telephone Number	:	336-293-8728
Fax Number	:	336-293-8733

Provider Business Practice Location Address
First Line	:	3009 WAUGHTOWN ST
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27107-1634
Country	:	US
Telephone Number	:	336-293-8728
Fax Number	:	336-293-8733

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2012
Last Update Date	:	03/15/2016

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