Provider Demographics
NPI:1215718366
Name:METWALY, EMILY AERAN MARISE (RN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:AERAN MARISE
Last Name:METWALY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2847 7TH ST W APT 204
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-6925
Mailing Address - Country:US
Mailing Address - Phone:678-538-8456
Mailing Address - Fax:
Practice Address - Street 1:510 4TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1914
Practice Address - Country:US
Practice Address - Phone:701-476-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN318933163WH1000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH1000XNursing Service ProvidersRegistered NurseHospice