Provider Demographics
NPI:1114704251
Name:EMERSON, JANICE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:EMERSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 SECOND ST S
Mailing Address - Street 2:
Mailing Address - City:FOLKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:31537-8447
Mailing Address - Country:US
Mailing Address - Phone:912-496-0041
Mailing Address - Fax:
Practice Address - Street 1:3435 SECOND ST S
Practice Address - Street 2:
Practice Address - City:FOLKSTON
Practice Address - State:GA
Practice Address - Zip Code:31537-8447
Practice Address - Country:US
Practice Address - Phone:912-496-0041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN277066163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice