Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 5007178 | NC |
NPI | 1477965994 |
---|---|
Provider Name | Emily Caroline Jaynes Honeycutt |
First Address | Winston Salem, NC 27157-1052 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2014 |
Last Update Date | 19/09/2017 |