Provider Demographics
NPI:1225869589
Name:PAUL, EMILEE DIANE
Entity type:Individual
Prefix:
First Name:EMILEE
Middle Name:DIANE
Last Name:PAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 CREEHILL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FORKLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36740-3312
Mailing Address - Country:US
Mailing Address - Phone:205-218-6997
Mailing Address - Fax:
Practice Address - Street 1:360 CREEHILL CREEK RD
Practice Address - Street 2:
Practice Address - City:FORKLAND
Practice Address - State:AL
Practice Address - Zip Code:36740-3312
Practice Address - Country:US
Practice Address - Phone:205-218-6997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program