Provider Demographics
NPI:1457695819
Name:MACGILLIS, EMILY KATHERINE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:KATHERINE
Last Name:MACGILLIS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:KATHERINE
Other - Last Name:NEUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2430 EMERALD PL STE 201
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5743
Mailing Address - Country:US
Mailing Address - Phone:527-522-1402
Mailing Address - Fax:
Practice Address - Street 1:2430 EMERALD PL STE 201
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5743
Practice Address - Country:US
Practice Address - Phone:527-522-1402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9523070163W00000X
VA0024170455367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse