Provider Demographics
NPI:1003393224
Name:EMERSON, KELLY M (CRNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:M
Last Name:EMERSON
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:520 JEFFERSON AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2538
Mailing Address - Country:US
Mailing Address - Phone:724-689-1822
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:508 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-1702
Practice Address - Country:US
Practice Address - Phone:724-547-1636
Practice Address - Fax:724-547-1762
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN602996363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily