Basic Information
| Provider Information | |||||||||
| NPI: | 1902268394 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNCAN | ||||||||
| FirstName: | EMMA | ||||||||
| MiddleName: | CAROLINE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2043 N MOHAWK ST | ||||||||
| Address2: | UNIT 1S | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606144565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3122084829 | ||||||||
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| Practice Location | |||||||||
| Address1: | ST. JOHN'S REGIONAL MEDICAL CENTER - 1600 N ROSE AVENUE | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 0000000000 | ||||||||
| FaxNumber: | 8054853025 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2016 | ||||||||
| LastUpdateDate: | 01/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 209.013732 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 95011709 | 01 | CA | NP LICENSE | OTHER |