Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 559 | NC |
NPI | 1134510183 |
---|---|
Provider Name | Jessica Lynn Emly |
First Address | Greensboro, NC 27408-7600 |
Second Address | Greensboro, NC 27405-6967 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2015 |
Last Update Date | 18/08/2021 |