Provider Demographics
NPI:1043707441
Name:AMOS, EMILY BETH (FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BETH
Last Name:AMOS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21212 NORTHWEST FWY STE 225
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5885
Mailing Address - Country:US
Mailing Address - Phone:281-469-8414
Mailing Address - Fax:281-469-6213
Practice Address - Street 1:21212 NORTHWEST FWY STE 225
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5885
Practice Address - Country:US
Practice Address - Phone:281-469-8414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty