Provider Demographics
NPI:1043042880
Name:LAO, EMILOU CAMOTES (FNP-C)
Entity type:Individual
Prefix:
First Name:EMILOU
Middle Name:CAMOTES
Last Name:LAO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 852
Mailing Address - Street 2:
Mailing Address - City:RED SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28377-0852
Mailing Address - Country:US
Mailing Address - Phone:646-992-0638
Mailing Address - Fax:
Practice Address - Street 1:200 FORSYTHE ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5426
Practice Address - Country:US
Practice Address - Phone:910-824-7619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5020681363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner