Provider Demographics
NPI:1093427247
Name:CHERUBIN, EMMANUELA (APN)
Entity Type:Individual
Prefix:
First Name:EMMANUELA
Middle Name:
Last Name:CHERUBIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11314 SILVER BAY CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8228
Mailing Address - Country:US
Mailing Address - Phone:502-417-5261
Mailing Address - Fax:
Practice Address - Street 1:3519 TOWN CENTER BLVD S STE B
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1001
Practice Address - Country:US
Practice Address - Phone:281-240-0311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1094482363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health