Provider Demographics
NPI:1134679277
Name:EMMERTH, CORINNA
Entity Type:Individual
Prefix:
First Name:CORINNA
Middle Name:
Last Name:EMMERTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 S MARIETTA ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1166
Mailing Address - Country:US
Mailing Address - Phone:740-310-9039
Mailing Address - Fax:
Practice Address - Street 1:177 S MARIETTA ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1166
Practice Address - Country:US
Practice Address - Phone:740-310-9039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.019977363LF0000X
WVAPRN59392-FNP-BC363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily