Basic Information
| Provider Information | |||||||||
| NPI: | 1013525849 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEGENKA | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | CAROLINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 353 CATTLE DR | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287897074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285060021 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 HOSPITAL ROAD | ||||||||
| Address2: | |||||||||
| City: | CHEROKEE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284979163 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2020 | ||||||||
| LastUpdateDate: | 07/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 5013201 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.