Provider Demographics
NPI:1265822845
Name:MUSCALUS, EMILY K (CRNP)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:K
Last Name:MUSCALUS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:K
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:1824 GOOD HOPE RD
Mailing Address - Street 2:
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-1233
Mailing Address - Country:US
Mailing Address - Phone:717-732-8877
Mailing Address - Fax:717-732-9241
Practice Address - Street 1:1824 GOOD HOPE RD
Practice Address - Street 2:
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-1233
Practice Address - Country:US
Practice Address - Phone:717-732-8877
Practice Address - Fax:717-732-9241
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014541363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102996049Medicaid
PA102996049Medicaid