Provider Demographics
NPI:1316174220
Name:BEARSE, EMILY C (CNP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:C
Last Name:BEARSE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9235 LAKE BRADDOCK DR
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2052
Mailing Address - Country:US
Mailing Address - Phone:303-999-6581
Mailing Address - Fax:
Practice Address - Street 1:8316 TRAFORD LN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1654
Practice Address - Country:US
Practice Address - Phone:703-569-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-RXN.0101300-C-NP363LP0200X
VA0024168295363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics