Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 252210 | TX |
N | 363LN0000X | Nurse Practitioner - Neonatal | 252210 | TX |
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP104642 | TX |
NPI | 1073792107 |
---|---|
Provider Name | Terry Emerson |
First Address | Amarillo, TX 79106-1708 |
Second Address | Amarillo, TX 79106-1786 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2007 |
Last Update Date | 03/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1877 | (05) | TX |
187731801 | (05) | TX |
187731802 | (05) | TX |
187731803 | (05) | TX |
187731804 | (05) | TX |
200079990A | (05) | OK |
36258270 | (05) | NM |