Provider Demographics
NPI:1083170161
Name:BOBE, EMILY JO (FNP-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JO
Last Name:BOBE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 WILLOW ST STE 203
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-1029
Mailing Address - Country:US
Mailing Address - Phone:812-886-4572
Mailing Address - Fax:812-886-6571
Practice Address - Street 1:700 WILLOW ST STE 203
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1029
Practice Address - Country:US
Practice Address - Phone:812-886-4572
Practice Address - Fax:812-886-6571
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71008769A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner