Provider Demographics
NPI:1316773682
Name:VENABLE, EMILY BRYANNE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:BRYANNE
Last Name:VENABLE
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 1:1224 E GRUMLING RD
Mailing Address - Street 2:
Mailing Address - City:HODGES
Mailing Address - State:SC
Mailing Address - Zip Code:29653-9317
Mailing Address - Country:US
Mailing Address - Phone:864-323-6999
Mailing Address - Fax:
Practice Address - Street 1:530 13TH ST NE UNIT 2
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-2176
Practice Address - Country:US
Practice Address - Phone:864-323-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program