1588865331 NPI number — MRS. EMILY P OUSLEY RN CNM

Table of content: MRS. EMILY P OUSLEY RN CNM (NPI 1588865331)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588865331 NPI number — MRS. EMILY P OUSLEY RN CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OUSLEY
Provider First Name:
EMILY
Provider Middle Name:
P
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588865331
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/05/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 S POST RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHELBY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28152-6269
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
980-484-5236
Provider Business Mailing Address Fax Number:
980-484-5118

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
315 E GROVER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHELBY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28150-3919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-484-5140
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X , with the licence number:  30 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 030 . This is a "CNM #" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 080542 . This is a "RN#" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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