Provider Demographics
NPI:1366077430
Name:DELEON, EMILY NEAL (APRN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:NEAL
Last Name:DELEON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:NEAL
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5126 MORNING FROST PL
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-3576
Mailing Address - Country:US
Mailing Address - Phone:803-630-7010
Mailing Address - Fax:843-913-8372
Practice Address - Street 1:4612 OLEANDER DR STE 102
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5711
Practice Address - Country:US
Practice Address - Phone:843-945-8117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-09
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23537363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily