Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | APRN.CNP.020001 | OH |
NPI | 1053869669 |
---|---|
Provider Name | Stephanie Emmett |
First Address | Mayfield Heights, OH 44124-2270 |
Second Address | Cleveland, OH 44124-2203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2016 |
Last Update Date | 17/02/2017 |