Provider Demographics
NPI:1518792548
Name:PEARSON, EMILY BROOKE (FNP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:BROOKE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 E 67TH WAY
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-1304
Mailing Address - Country:US
Mailing Address - Phone:310-614-1804
Mailing Address - Fax:
Practice Address - Street 1:360 E 67TH WAY
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-1304
Practice Address - Country:US
Practice Address - Phone:310-614-1804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95032043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily