Individual
EMILY PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1650 SKYLYN DR STE 120, SPARTANBURG, SC 29307-1069
(864) 216-4525
(864) 216-4514
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
22603
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6551
—
SC
01
—
SCG6186067
MEDICARE PIN
SC
Enumeration date
09/02/2019
Last updated
11/25/2020
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