Emily Ann Dyer
Individual provider Active NPI Athletic Trainer · Purlear, NC
NPI 1497301121 · NPPES record last updated Sep 25, 2024
Key facts
- NPI
- 1497301121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- LAT-4890 (NC)
- Practice address
- 246 Mountain Shadows Dr
Purlear, NC 28665-9400 - Phone
- (336) 907-6812
- NPI assigned
- Aug 19, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAT-4890 | NC | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | LAT-4890 | NC | Yes |
Addresses
Primary practice location
246 Mountain Shadows Dr
Purlear, NC 28665-9400
Mailing address
4948 Nottingham Place LN Apt 202
Winston Salem, NC 27106-4895
Phone (336) 907-6812
Other providers in Purlear, NC
All providers in Purlear, NC · Athletic Trainer in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.