Provider Demographics
NPI:1093351595
Name:JAMETT, EMILY JANINA (CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JANINA
Last Name:JAMETT
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:JANINA
Other - Last Name:PICHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP-PC
Mailing Address - Street 1:31815 SOUTHFIELD RD STE 10
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-5471
Mailing Address - Country:US
Mailing Address - Phone:248-644-2700
Mailing Address - Fax:
Practice Address - Street 1:31815 SOUTHFIELD RD STE 10
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:MI
Practice Address - Zip Code:48025-5471
Practice Address - Country:US
Practice Address - Phone:248-644-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704313738363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics